The Therapeutic Relationship in Context:
– Finding the Person-Centered Approach in Homeopathy.
Ian Townsend, FSHom, FHEA, M.A.
The following paper draws from a presentation given by Ian to the 25th Anniversary Meeting of the Association for the Development of the Person-Centered Approach, at the University of Loyola, Chicago, ILL. July 27-31, 2011. It draws from his lifelong experience of person-centred practice. The paper was written for an audience of counsellors and psychotherapists unfamiliar with homeopathy, and its original shape is retained to give homeopathic readers a sense of the background presented.
Champions of the person-centred approach (‘PCA’ hereafter) are to be found in many disciplines: their occurrence in fields such as counseling, psychology, psychotherapy, education, nursing, social work, and politics is well known.
However PCA’s place in CAM (complementary and / or alternative medicine) remains largely unexplored. This paper suggests remarkable similarities exist between the philosophy and practice of one branch of CAM – homeopathy – and the philosophy and practice of the PCA.
The similarities have gone largely ignored by both disciplines. So we will explore them, and discover that many of Roger’s person-centred tenets were present in the work of homeopathy’s originator 200 years ago. We will notice others currently being ‘rediscovered’ (sometimes acknowledged, but mostly unattributed) by homeopaths.
Personally, the visions and practices of Rogers and his colleagues have weaved their way through my life since the 1960s, and today, writing as a retired practitioner of one type of complementary medicine – homeopathy, whilst working as a trainer of another discipline – counseling, I’d like to share some ideas about the similarities existing between the two disciplines.
I can’t quite remember when I first came across the person-centred approach – trying to place it for this meeting, I reckon it must have been in the final years of my teacher-training course in the late 60s when I was introduced to ‘Freedom to Learn’, (checking my bookshelves, I see my copy of Rogers’ seminal book ‘On Becoming a Person’ is dated 1973).
I was introduced to Re-Evaluation Co-Counselling at the Institute for the Development of Human Potential at the University of Surrey, and, inspired by the talks of Jean Houston, seriously considered training in counselling. In fact, back in the 1980s, following their initial trainings, I had been accepted for and was faced with choosing between professional training in either Psychosynthesis or Transpersonal Psychology when I happened to be visiting a friend in the north of the UK. ‘Can’t come out with you tonight’, she said, ‘I’m going to a talk at my local dentists’.
Intrigued by this (for who would want to go to their dentists voluntarily ?) I agreed to accompany her. The talk was by her dentist’s daughter, who was a homeopath, the approach sounded fascinating (and, in my naivety, easy !) – and within a week I had applied for, been interviewed by / interviewed the Dean of the School in Newcastle – and was in a classroom learning homeopathy.
Through all that, I always found myself being drawn back to the person-centred approach, and I spent the last decade struggling with and working out how to make that approach real for my students within their practice of homeopathy.
The New England Journal of Medicine reported that 2.5 million Americans used homeopathic remedies and 800,000 patients visited homeopaths in 1990, and it has continued to grow.
In the United Kingdom, various forms of complementary and alternative medicine have enjoyed considerable public support. My discipline, homeopathy, was one of the ‘Big 5’ complementary medicines to be recognized at governmental level (House Of Lords Select Committee on Science and Technology, 2000). Chiropractic achieved statutory recognition (and regulation) a number of years ago, Herbal medicine recently achieved this.
Worldwide, homeopathy is one of the most popular CAM therapies (WHO, 2005), the second-most used healing method, one in common use in Europe – practised in 41 out of 42 European countries (Bhatia, 2010); in India, South America and the U.S. It is integrated into national health care in Brazil, Cuba, India, (Kalra & Bhugra,2010) and Mexico, with approximately 200,000 homeopathic doctors graduating from over one hundred and eighty 5-year colleges in India alone (ibid).
In the early 1900s, homeopathy was popular . . . with over 15 percent of all doctors being homeopathic. There were 22 major homeopathic medical schools, including Boston University and the University of Michigan. However, with the formation of the American Medical Association, which restricted and closed down alternative practices, homeopathy declined for half a century. When the 1960s invigorated back-to-nature trends and distrust of artificial drugs and treatments, homeopathy began to grow again dramatically through the next decades. In 1993,
Anon, 2011 [online]
The last few years have seen determined opposition to the practice of homeopathy – and especially to it’s place in our university system. Evidence-based scientists decry it’s basic premises, wryly commenting on the supposed effectiveness of medicine which, after all, is diluted past ‘just a drop in the ocean’. [House of Commons Science and Technology Committee (2010)]
So – What is homeopathy ?
Simply, it is an holistic system of medicine which originated in Germany in the late 1700s.
[A useful timeline for it’s development can be found at http://www.google.co.uk/search?client=safari&rls=en&q=homeopathy+in+germany&ie=UTF-8&oe=UTF-8&redir_esc=&ei=GK9bTer7GpGYhQehz-nCDQ#q=homeopathy&hl=en&client=safari&sa=X&rls=en&tbs=tl:1,tll:1740,tlh:1759&prmd=ivns&ei=_LFbTfrhJMHPhAf59JSJDQ&ved=0CG4QyQEoAQ&fp=397cc9d4fe1816bd]
Although it can (and has been) used to treat acute conditions and emergencies as well as physical, emotional, and mental states, “patients largely seek homeopathic treatment for symptoms of chronic long-lasting illness (Witt et al. 2005, Relton et al 2007)”
Its originator, Dr. Samuel Hahnemann (1755-1843), was, if you like, the Nikolas Tesla of his time. A qualified doctor, distinguished scholar, scientist, researcher, and considerable linguist, I’m often amused by the derision and contempt homeopathy attracts today from so-called scientists, especially those skeptical fundamentalists who seem ignorant of the fact that it was Hahnemann and homeopathy that laid the foundations for much of present medical practice: the importance of diet, exercise, and a healthy work-life balance, vaccination and desensitization; awareness of both environmental toxins and an early germ theory of disease were all developed by this German doctor (Hanson 2010, Schmidt 2010:194).
Perhaps more surprisingly for an audience of counsellors, it was out of Hahnemann’s early experiences (1792-1796), observations and experiments that the idea of gentle psychiatric treatment (Merizalde, 2008) and also drug testing (a mainstay of modern medicine) was developed. As Hanson (2010:5) pointed out
“Hahnemann was a brave scientist and a researcher, a frustrated doctor disenchanted with the allopathic approaches of his day; a man who clearly aspired to being, not only a researcher, an experimenter, a trailblazer and a better doctor, but also a healer . . . “
Indeed, Bohn (1970, from a conference paper given in 1960; Morrell’s 2010 paper explores this area in more detail), says
“Hahnemann was the first medical writer to proclaim the curability of mental illness; he first differentiated organic from functional mental illness; he recognized the development of irreversible changes in chronic mental illness, and advocated early treatment; that he recognized the universality of mental illness and the influence of psychiatric implications in organic illness; that he stressed the mental symptoms in his materia medica and left us a wealth of remedies that still work just as well as they did in his day.”
Over the next 40 years, working “. . . in some 25 towns and cities in modern Germany, Austria, Romania, and France.” (Schmidt 2008:127), Dr. Hahnemann developed the system of homeopathy in response to the barbaric medical practices of the time. (Letzel 2009). With a grounding in criminal and accidental toxicology (what we would today call forensic medicine) and the wider (European and Arabic) literature of medical practice of the time, he discovered via a series of clinical case observations and trial-and-error experimentation that substances which gave rise to symptoms were also effective in curing those symptoms (what came to be known as the principle of like cures like).
More surprisingly, Hahnemann found that reducing the dosage had little effect on a medicine’s effectiveness [Klüssendorf (2009a, 2009b, 2010a, 2010b)], that doing less and less (does that sound familiar to person-centred practitioners ?) resulted in more and more.
The Place of Symptoms
Let’s take a pause here, and consider the place of symptoms. In the accepted western system of medicine, the purpose of any enquiry is to identify symptoms which can help identify a known clinical entity, for which a treatment can be offered. Symptoms not fitting into that evolving picture are often discarded or ignored, and of course, symptoms which aren’t offered by the patient sometimes don’t make it into the picture at all.
If we are consulting for something to do with a specific body system, often symptoms in other systems aren’t considered. The criticism is that, effective though western medicine may be, it often treats the symptoms, not the cause:
‘Local treatment only interrupts and confounds the larger cycle, leaving untouched the original problem.’
With Hahnemann, symptoms became classified, detailed, differentiated – and, very importantly, – related to the whole person. Before the idea of ‘holistic health’ or ‘satisfying patient needs’ was recognized, homeopathy was recognizing systems-of-relatedness present in what C21st orthodox medicine would still regard as very disparate sets of symptoms.
As Iris Bell, Professor of Family and Community Medicine at the University of Arizona, writes:
Symptoms can be bio-psycho-social- spiritual in nature, typically including both disease-specific and nonspecific manifestations. Grasping patterns and themes of the symptoms is crucial . . . homeopaths synthesize their observations of a patient’s appearance, verbal and nonverbal behaviors, resilience to daily hassles and major life events, personal medical status and history, family history, and capacity to live fully in joy and purpose.
Bell et al (2004:124) added emphasis
A Vitalistic, Holistic, Spiritual Outlook
Through his lifetime, Hahnemann moved from a reductionist, material view of health and disease to one which became increasingly vitalistic, energetic. He drew from a millennial tradition known as vitalism: the idea that there is a life energy – that extra spark which animates – present within every living thing; that the individual is more than the sum of any or all of its parts (the body and body systems); and that it is this vital force or life energy which imbues, informs, and directs the development of the organism. Interestingly, Rogers’ concept of a motive force — whose predeterminants lay the work of Maslow and several other biologists (see Thorne, 1997; Bozarth, 1998) – places the actualising tendency within this same tradition. (Townsend 2002:82)
Very early in the development of homeopathy, Hahnemann was recommending the practitioner take a very deep and far-reaching case history, based in the reporting of the patient:
The patient details the history of his sufferings; those about him tell what they heard him complain of, how he has behaved and what they have noticed in him; the physician sees, hears, and remarks by his other senses what there is of an altered or unusual character about him. He writes down accurately all that the patient and his friends have told him in the very expressions used by them. Keeping silence himself he allows them to say all they have to say, and refrains from interrupting them1 unless they wander off to other matters. The physician advises them at the beginning of the examination to speak slowly, in order that he may take down in writing the important parts of what the speakers say.
1 Every interruption breaks the train of thought of the narrators, and all they would have said at first does not again occur to them in precisely the same manner after that.
(Hahnemann, 1810 / 1842 / 1996: $84)
For more detailed and accessible accounts of homeopathy see Bell (et al.) 2004, 2006, 2010 or Townsend (2002). Sufficient here to say that on the basis of the results of the case history, practitioners prescribe one treatment (medicine). That’s not a medication for the migraines, another for the arthritis, yet another for the high blood pressure, and various others to reduce the potential or very real side effects of those already prescribed, it is one medicine for the unique individual who happens to suffer from all those clinical entities.
And it’s not, usually, a course of one sort of medication. It’s one treatment, one intervention, often just one pill. Homeopathy takes holistic account of where, when, and how a patient is, and attempts to provide one therapeutic intervention – in as minimal a form as possible.
I can still remember my first successful case, treated almost 3 decades ago now. A woman in her late 30s, I initially mistook her to be in her 50s. On strong medication for crippling arthritis, suffering from attacks of rage pre-menstrually (she told me in all seriousness she had to lock the knife drawer in her kitchen at those times), disabled by frequent severe migraines, always dressed in drab clothing in black or grey: not unsurprisingly she also reported low self-esteem and relationship problems. It took a number of attempts at finding a treatment suitable for her (I was beginning to find out that homeopathy wasn’t as simple as I’d originally thought !)
The result of the successful medicine surprised me. I simply didn’t recognize her at her follow-up appointment the following month. The clothes she wore had completely changed (she gleefully told me she had thrown her old wardrobe out and replaced it with stylish and colorful outfits), she literally looked years younger, was not suffering from the symptoms which had always accompanied her menstruation, and her crippling arthritis was easing to the extent that (under the guidance of her general practitioner) she was seriously reducing her orthodox medication.
As I noted in a previous paper “patients are surprised when they get emotional, mental, and spiritual benefits from a treatment they regard as “only to do with the body”” (Townsend, 2002:85).
Now I’m not telling you that story to brag about what a wonderful practitioner I am ) . . . I’ve always thought of myself as a fairly pedestrian prescriber, getting there most of the time by plodding from point A to point B to point C, and so on (often right through to point Z) . . . I’m recounting the story to make the point that in this particular complementary medicine – homeopathy the carefully-selected medicine chosen on the basis of a client’s reported and observed physical, mental and emotional states can have wide-reaching effects.
Which leads us to a short discussion of where homeopathic remedies come from, how they are prepared, and how they are prescribed.
The Proving Story
Although a number of recent papers (Brien et al, 2010; Hanson 2010; Hartog, 2009; Zadorozhneva 2011:9 ) suggest that
“Homeopathy confers significant clinical benefit through the consultation process, but not the homeopathic medication.”
(Brien et al, 2010:8)
such a conclusion is probably still hasty. There are ample reports, single case studies, case series, comparative studies, which show the impact of homeopathic medicines on human, animal and plant populations, as well as its effects in the laboratory on tissue samples.
See, e.g. British Homeopathic Association (2010), Dantas & Fisher, 1998, Faculty of Homeopathy (2011), or Walach, Jonas, Ives, Van Wijk and Weingärtner (2005)
The fact is that homeopathic medicines can be prepared from any substance imaginable, indeed, from any substance unimaginable as well. You may be surprised to find America richly represented in the homeopathic pharmacopeia – with common medicines made from poisoned ivy, and more surprising ones made from the blood of the Bald Eagle, others from what used to be (and still may be, for all I know) popular spring waters.
Hahnemann created a particular technology for preparing these which is entirely different to other methods of producing “medicine’’ and which continues to be used to this day; the process of triturition, dilution, and serial succussion and dilution. Initially a source material is converted into a form in which it can conveniently be ground in a pestle and mortar with sac lac – sugar of milk. It is dissolved, purified, and a starting dilution prepared. This is then serially diluted and succussed as many times as necessary, giving rise to solutions called ‘potencies’ which are then placed on the tiny pills familiar to many homeopathy users.
But, you may argue, this is not so different from modern-day pharmaceutical manufacture.
Hahnemann’s genius was, firstly, to find a method of preparation which refined and purified any potentially medicinal substance past the point at which matter existed in it; secondly, to evolve a protocol which mapped the holistic impact on human systems, thirdly, to see the link between symptoms produced and symptoms cured.
Do you remember that earlier we talked about the idea of as like cures like ? Hahnemann discovered that when applied to healthy human populations homeopathically-produced substances produced an effect, and that this effect (the resulting symptom-map) could be successfully used curatively as a mirror when part or all of it was found in ill individuals.
The process of Proving (Hahnemann 1842, Sherr 1994, 2007) is homeopathy’s technology for achieving this. There is, in this, the animistic / shamanic / Taoistic idea that every organism or substance is imbued with its own pattern or blueprint. (Sheldrake 1981, 1988). Investigations of homeopathic succussed dilutions reveal structural and energetic differences and the significance of this is that, we think, the particular process of preparing a homeopathic remedy increasingly clarifies it’s blueprint picture the more refined (diluted) the remedy becomes.
A bit like taking a badly-preserved phonograph recording from the late 1800s, and running it through increasingly sophisticated C21st audio software, the crackling inaudible message becomes clearer and clearer; or like, rather than listening to that early 45 r.p.m. vinyl on your Dansette, using the very best amplifier and headphones you can buy – and hearing details you never heard in the original !
Homeopathic provings involve blind testing of chosen substances on populations, and the careful elucidation of the resulting symptom pictures which then occur in these populations. Provings are being carried out all over the world (see, for example, http://www.hominf.org/proving.htm, http://www.smeddum.net/content/provings.htm, http://www.provings.info/en/einleitung-proving.html) with Jeremy Sherr, (an Israeli homeopath who now works in Africa with Aids patients) being their foremost contemporary proponent.
He writes about their shamanic aspects:
In a proving one becomes the remedy. The spirit of the remedy invades the very centre of our being and prevails on every part of the economy, just as a virus takes over a cell nucleus and from there directs the entire cell to its own purpose . . . Through experiencing the new artificial persona of a remedy we travel to inner places that we would never otherwise have encountered, unlocking hidden corners of our natural make-up . . .
We learn as much about our internal landscape as any traveller would learn of the various countries he or she passes through.
Or as Anita Barzman, a Board-Certified Psychiatrist and Analyst Member of the Society of Jungian Analysts of Northern California who has been working with homeopathy in her practice for the last fourteen years says:
“ . . . homeopathy can be seen as a practical application of alchemy, tapping into the endless Mercurial fountain, the mystery of the boundless spirit and energy that is present in matter, the source of healing vitality and animation that lives in a potential form in all of us.”
Interestingly, Robert Gable (Professor of Psychology, Claremount Graduate College, CA) describes what homeopaths would consider a personal proving experience with psilocybin in the 1960s (Gable, 1993)
From it’s inception, the aim of homeopathic treatment has been as radical and revolutionary as that of person-centred therapy. Hahnemann (1810:$9) explains that the purpose of homeopathic treatment is to enable individuals to enjoy a
“healthy condition . . . so that (we) can freely employ this living, healthy instrument for the higher purpose of our existence.”
A clearer statement of this can be found in Vithoulkas (1995), available at URL: http://www.vithoulkas.com/content/view/39/51/lang,en/ [Last accessed 21/2/2011]. Here, the internationally renowned alternative-Nobel-prize-winning homeopath George Vithoulkas describes the aim of homeopathic treatment as being ‘freedom from’:
pain in the physical body, having attained a state of well-being.
passion on the emotional plane, having as a result a dynamic state of serenity and calm.
selfishness in the mental sphere, having as a result total unification with Truth.
Two hundred years of homeopathic literature is filled with case reports showing this in action. Iris Bell & Mary Koithan, from the Departments of Family and Medicine, and the College of Nursing at University of Arizona, describe categories of transformational change such as increased self-actualization or sense of purpose in life in their presentation of three exemplar homeopathic cases which (if you did not know about this discipline) you might only ascribe to good therapy. (Bell & Koithan, 2010:62)
They go on to talk about the multidimensional nature of patient outcomes in homeopathic treatment: pointing out how a consideration of the patient as an indivisible, dynamical system or network of interdependent, interactive parts, whose overall behaviors are emergent properties of the person as a whole, behaviors not predicted from understanding the separate capacities of the isolated parts . . . leads to . . . spiritual, social, mental, emotional, and physical realms all undergoing profound shifts in a transformational outcome with homeopathy. (ibid:68)
Meeting The Patient
The idea of letting the patient speak, and, indeed, listening carefully to what s/he has to say is fundamental to the homeopathic approach – indeed, from the 1800s to the present day, this is stressed by author after author (e.g. Hahnemann 1810; Kent 1900; Close 1924; Roberts 1936; Wright Hubbard 1967; Whitmont 1980; Sankaran 1994; Vithoulkas 2000; Kaplan 2001; Thompson & Weiss 2006; Johannes 2010). A detailed analysis of it’s developmental chronology is given in Dannheisser (2009).
It appears the emphasis has always been to ground the homeopathic interview in the patient-centred reporting of her experience, her concerns, her clinical pathology. The homeopathic interview represents a profound daily searching of each patients’ inner world:
“The physician…needs to be like an archaeologist who excavates a treasure without touching it, interfering with it, labelling or classifying it, but purely unearthing it and making it stand out so clearly that there can be no controversy as to what it is. To do this is an art. One does not add to or subtract from, interpret or analyse anything concerning the patient. One only has to uncover the patient’s inner turmoil, so that it is seen as clearly and in as much detail as is possible. One is only required to bring that which is hidden in darkness to light, to make what was unknown known. It is not simply ‘case taking’ but ‘case uncovering’ to the very depth.”
Indeed, as Bohn (1970), Clover (1977) and Dannheisser (2009:13) have all shown, Hahnemann’s original (1842) guidelines for the medical interview anticipate the advent of professional Psychology: “in 1842 in America, Samuel Schmuker published the book Psychology: Elements of a New System of mental Philosophy or The Basis of Consciousness and Common Sense, in 1890 William James published Principles of Psychology and Freud’s psychoanalytic paper, Study on Hysteria was published 1895 [ http://www.geocities.com/athens/delphi/6061/en_linha.htm#-600 and http://en.wikipedia.org/wiki/Sigmund_Freud#Major_works_by_Freud ] both accessed 2/7/09.”
As an aside – Yalom’s fictional (2005) account of the development of the interview methods of Breuer and Freud are surprisingly familiar to those of the homeopathic interview. I am indebted to my colleague, Paula Seth, for bringing this to my attention. (Seth, 2011)
Bohn’s article refers to a conference paper he gave in 1960, where he established Hahnemann contemporary with, if not precursor to a full flowering of psychiatric thought. Hahnemann’s 1842 Organon carries the first recorded recognition of purely functional mental illness (Bohn 1970:113) and, he continues, makes references “to psychotherapy and is basically descriptive of the types in use today. We have added some refinements and have clothed them in beautiful, modern nomenclature so that they sound most impressive, but essentially they are unchanged.” (Ibid, 112-113)
With such a focus on the patient it is unsurprising to homeopaths to hear, as one of the respondents in Hartog’s (2009) review Elements of effective communication – Rediscoveries from homeopathy in the Journal ‘Patient Education and Counseling’ reported
‘‘Well, my own doctor listened for years and years, but I mean this doctor really listened. I felt for the first time someone really paid attention.’’
In fact, the homeopath listens so carefully that Johannes (2010) was able to make a strong case for viewing the homeopathic interview as counselling, concluding
The homeopath employs listening skills that encourage a complete and open-ended phenomenological “coming to terms” across mind-body-spirit dimensions of experience. The homeopath’s active and reflective listening skills encourage the client’s ability to put their experience (e.g. symptoms, reactions, dispositions) into words (“come to terms”) thereby distilling and clarifying insight, order, structure, meaning, and some measures of acceptance, control, value, and/or distance from the experience to therapeutic effect . . . – Homeopaths are, therefore, already providing counselling whether they bill themselves that way or not .
Anna Thorley, for twenty years Director of the Lindisfarne Centre in Newcastle-upon-Tyne, in a clinical practice involving both homeopathy and Jungian work, comments
I have spoken with many homeopaths over the years who have been told “You are not a counsellor” or been asked to choose between being a homeopath and being a counsellor. Yet the minute we enter a room with an expectant, suffering person, a kaleidoscope of emotion constellates within each of us and between us that we do well to take into account.”
I will pick this argument up again in the closing moments of this paper.
We’ve talked briefly about some of the key ideas familiar to homeopaths the world over:
Homeopathy describes a process view of the ways in which individuals become ill and either recover from that illness or develop lifelong conditions, and are thus affected in their ability to lead a healthy (self-actualizing) life, or, as Bozarth and Brodley (1991:47) put it: ‘to respond to unfavourable, inadequate or destructive environmental circumstances’.
Through it’s proving methodology which gives rise to therapeutic medication, it provides a technology for countering, halting or reversing the disease process, and promoting health.
Homeopathy recognizes the nature of life’s journey, with its rich contextualization, its interdependence and the ever-present links between the inner and the outer, the higher and the lower (Broom, 1997). In acknowledging this, homeopathy describes the links between psyche and soma (Whitmont, 1991).
In effect, it proposes a mechanism which is holistic, unitary and holographic, characterized by Bohm (1980) as ‘undivided wholeness in flowing movement’ (p. 161). In doing so this 200 year old body of knowledge remains in line with more recent ideas of leading-edge biology (Bohm, 1980; Sheldrake 1981,1988; Webster and Goodwin, 1996). [Townsend 2002:82]
“all healing involves, in some fashion, the following elements: understanding the problem, providing the conditions conducive to healing, mobilising resources to effect healing, new growth, and reconciliation.”
Psychology, the Person-Centred Approach & Homeopathy
So, you may be wondering, why talk about homeopathy here today in this person-centred conference ?
Reporting from the University of Vanderbilt Medical Center’s Department of Psychiatry in a 1995 Symposium on Psychotherapy in the Age of Managed Care, Roback et al. (1999:5) observed that
“We are not a united group, but rather a deeply divided group of mental health providers. We are similar to 19th-century medical professionals. In the 19th century there was no such thing as medicine. There were the holistic doctors, the homeopaths, and the “regular” physicians. These groups had mutual contempt for one another. In the 20th century, there was some coming together of medicine. But we are still in a very sectarian state. We do not respect one another. A quiet, furious war rages between the psychoanalytic community and the pharmacologic community.”
I wonder if this state of affairs still holds true a decade later ? Benor (2005, 2008) rather suggests it does.
Strangely, although there has been little of substance published which links our two disciplines together, there is a thin red thread running from the early decades of the 1900s to the present.
The most detailed tracing of that link that I can find in the psychotherapeutic literature occurs in Riebel’s seminal paper in the Journal of Humanistic Psychology in 1984.
Linda Riebel gained her early degrees in history, went on to take a Masters’ in Psychology from Goddard, and then received her Ph.D. in 1981 from Saybrook Institute (formerly the Humanistic Psychology Institute), where she studied paradoxical strategies in psychotherapy. She practiced as a psychotherapist in Berkeley, Ca. for 25 years and now works as an author and instructor of academic writing, critical thinking, and sustainability.
In 1984 she published a paper out of her Doctoral dissertation which reviewed psychoanalysis, catharsis, gestalt awareness techniques, Rogerian acceptance and paradoxical intention strategies.
In the course of a broad-ranging tour of the very different models then available for psychotherapeutic intervention, she proposed an overarching paradigm which distinguished between those techniques which were authoritarian, didactic, and expert in approach (which she termed ‘allopathic’) and those which ‘called on the client to continue to have or intensify experience already present’ (Riebel 1984:9). Approaches she designated ‘homeopathic’.
Although not a trained homeopath (Riebel 2009, 2011) her description of the homeopathic approach is one of the clearest that this (homeopathic-, person-centred- trained) author has uncovered in the last 30 years.
In her careful review of literature, she traces psychology and psychotherapy’s mentionings of homeopathy through a number of authors from 1959 to 1981: Jackson (1959), Haley (1963), Watzwalick, Beavin & Jackson (1967), Zeig (1980), and Malcolm (1981), authors who lead us right back to the dawn of psychotherapy (Freud 1914, 1917).
A further review by this author reveals a similar number of sightings in your professional literature: Burnard (1986, 1987), Schott & Schott (1990), Lietaer (1998), Townsend (2002, 2004a &b). Some of these sightings draw parallels between the philosophy and practice of homeopathy and that of psychotherapy. Relatively few of them make the specific link between the person-centred approach and homeopathy: Lietaer (1998), Riebel (1984), Townsend (2002, 2004a, 2010). Equally rare are those that recommend psychologists or psychotherapists to become involved with CAM practitioners: White (2000,2009), or describe ways in which the two disciplines could work together with a common client: Ferris (2009), Schott & Schott (1990), Zahourek (2008).
Let’s take a brief look at some of these.
Levant & Shlien (1984)
In the same year that Riebel (Winter, 1984) was being published the influential edited collection of papers Client-Centered Therapy and the Person-Centered Approach contained the comment: ‘it is not a mistake when Rogerian therapy is called “homeopathic.” This supercilious accusation was made in scorn, but it is true and a compliment’. Levant and Shlien (1984:5)
Two years on the well-known English nurse educator Burnard picked up Riebel’s work in a 1987 paper on spiritual counseling; he cites it the following year in a paper whose background reveals an awareness of the humanistic psychology developments in the UK that I was already familiar with at the time.
Schott & Schott (1990)
A little later, in 1990 Eric and Ulrike Schott published a clinical case in the GwG Zeitschrift (the Journal of the Scientific Society for Person-Centred Psychotherapy) which illustrated how homeopathy and the person-centred approach worked together. Ivanovas and Petrossian (2004) contributed a similar discussion in another person-centred publication.
Then, nearly a decade later, exploring the issues of non-directivity against background developments of direction and manipulation in psychotherapy, Germain Lietaer again cited Riebel’s (1984) and Schott & Schott’s (1990) earlier publications, noting:
“Our client-centered therapeutic orientation has nevertheless kept a non-directive hue. Or, shall we say: a homeopathic hue. By this we mean that client-centered therapists view the human being as proactive and intent on self-realization and that they wish to leave this actualising tendency as much room as possible . . . (the method) . . . seems to remain more one of following than of steering and seems to show great respect for what can develop from within . . . In actual practice, this homeopathic attitude manifests itself in a minimal structuring of the therapeutic process and in a constant search to connect with the client’ inner compass.” Thorne & Lambers (1998:67)
Finally, I brought the similarities in the approach to the fore again in my substantial papers in the person-centred literature in 2002, 2004, and currently, here in Chicago today.
Like cures like similar suffering
Travelling in the opposite time direction, Riebel notices citations by Janet Malcolm, in her 1981 book Psychoanalysis: The Impossible Profession – where various authors’ comments on homeopathy are tabled:
“. . . The (homeopathic) idea of curing suffering with suffering . . . The ‘transference neurosis’ described by Freud as an artificial illness that the analysis itself brings into being . . .“
Malcolm (1981:126-127) in Riebel (1984:19)
Schutz & Turner’s (1976) book: Body Fantasy compares psychotherapeutic approaches to homeopathic principles concluding a case for ‘special recognition’, whilst 1968 saw Sherman & Coleman Nelson’s book Roles and Paradigms in Psychotherapy repeating the homeopathic analogy; Watzwalick, Beavin & Jackson’s (1967) Pragmatics of human communication remarks on homeopathy’s like curing like principle, as do family therapists Jay Haley’s (1963) Strategies of psychotherapy and Don Jackson ’s 1959 work. Finally, Freud’s early work contains remarks which would be very familiar to homeopaths.
It’s pretty clear that, whilst neither psychotherapy in general nor the PCA in particular have particularly embraced the discipline of homeopathy, whatever link might be present just won’t go away. Homeopathy, after all, is the medicine of the minimum dose, so perhaps we shouldn’t be surprised to find this.
But what about homeopathy ? Are its practitioners aware of counselling ideas ? Are they familiar with the necessary and sufficient (or even insufficient) conditions ? Does the work of Rogers, Gendlin, Mearns, Thorne, (etc.) have anything to say to my discipline ?
Homeopathy, Psychology, & the Person-Centered Approach
Of course it does. There’s an equally sporadic scattering of what one might term ‘psychological awareness’ in the homeopathic literature running from the 1790s, references to Jungian archetypology from the 1940s, and even more specific references to the person-centred approach from the 1980s to the present time. For a detailed listing of these see Townsend (2004a).
The inaugural (1983) Annual Conference of my professional body invited as its keynote address a paper from the British psychotherapist Ian Gordon-Brown. (Pool, 1991: p111). Gordon-Brown inhabited the far end of the humanistic spectrum (see, e.g. http://www.transpersonalcentre.co.uk/about.htm ), in the sense that his work was focused on using the many ways of expanding human consciousness to prompt the processes of self-realization or self-actualization.
Investigating this early link between British homeopathy and transpersonal psychology, I recently contacted various people from that time. The Society of Homeopaths had no clear memory of the events which led up to Gordon-Brown’s involvement (Treuherz, 2011), but Sarah Richardson, one of the original founder-members of the Society, remembers that in the late 1970s several of the North London Homeopathy group studying with John Damonte were involved attending his transpersonal psychology workshops. (Clarke, 2011). This was the seed group that went on to form the UK Society of Homeopaths – now the largest registering body of professional homeopaths in Europe.
Later addresses from the person-centred therapist and homeopath Miranda Castro approached the topics of supervision, relationship and power (reported in Castro; 1989, 1991, 1993.) Three other authors (Kaplan 2001, Spring (1990) and myself (Townsend 2002, 2004a, 2009, 2010, 2011) clearly link the homeopathic interview process to the person-centred approach with increasing detail.
The Berne-based homeopath, Beat Spring, was the first to remark on the obvious similarity between Rogers’ ideas and the homeopathic interview:
“In a person centred psychotherapy session, as taught by Carl Rogers in La Jolla, California, you very empathically listen to the report of the client. You abstain from any judgment or desire to give advice and literally try to understand and see the world through the eyes of the client. You may ask questions to get a better and deeper understanding of what he/she just said or give him signs of your understanding to encourage him. (Sounds like a good prescription in how to take the homoeopathic case doesn’t it)? . . You are not leading, but just following the process very attentively. You are not in the position of knowing better than the patient what he needs. You just help him find that out himself.”
Misha Norland (one of our C20th homeopathic founders and one of that original seed group) unconsciously touched on Rogerian concepts when he produced this metaphor for the homeopathic interview:
“I like to image a session as being like going for a walk with the other into their territory so that we are both experiencing this event together. This allows for empathy to coexist with objectivity, for they are showing me the sights, yet, if the going gets tough I am there alongside them.” (Norland, 1998: p10)
– which, you must admit – is a statement not so different the one appearing in Mearns & Thorne (1994: p43):
“Right from the start of the relationship the counsellor endeavours to enter the client’s frame of reference and walk alongside him in his world.”
or that of one of the participants in Dannheisser’s (2009:47) research study:
“ . . . the patient directs you to where the centre of the case is. If YOU direct THEM, you will get to the centre of the case where you assume it is, and that is absolutely not going to get you to the right place.”
The Australian homeopath, Alastair Gray (a student of Norland’s) realised during his training “it is safe to say that my principle homeopathic influences were in fact Perls, Rogers, Ram Dass and Kopp as much as Hahnemann, Kent and Vithoulkas. I looked at these homeopathic writings on what we should do in the clinic and thought there had to be more. . . . . seeing Whitmont in action in the early 1990s and reading Kaplan (2001)”. (Gray, 2009:2)
Brian Kaplan’s (2001) book was, for many of us homeopaths, a landmark publication. For the first time in the literature we see an orthodoxly-trained doctor embracing the practice of homeopathy, and proceeding to make sense of those interpersonal elements lacking in his medical training by identifying, applying, embracing and embodying the value of the person-centred approach within his homeopathic practice. Kaplan captures what I feel about the similarities between the homeopathic interview and the PCA:
“The classical homeopath is obliged to listen carefully to every word uttered by his patient. This is what makes our profession special. The undivided attention of the homeopath to his patient creates an atmosphere in the room in which the patient feels respected, understood, and even loved. This is the elegance of the homeopathic conversation.”
Later contributions from other homeopathic authors (considered below) will show how PCA components are being rediscovered by homeopathy.
Homeopathy & PCA – similar concepts
I hope you can start to see the picture emerging ? In some of its earliest writings, psychology showed an awareness of the discipline of homeopathy, to the extent of using similar language and ideas. I find it absolutely fascinating to notice that in the mid-50s psychotherapists writing about homeopathy were coming out of the provocative therapy tradition, and now, fifty years later to observe the internationally-renowned homeopath Brian Kaplan combining provocative therapy with his practice of homeopathy (Kaplan, 2011).
Furthermore, the similarities between the philosophy, theory, and in-the-consulting-room practice of our two disciplines are remarkably striking. The accompanying table identifies more than 20 points of similarity between my practice as a homeopath, and my practice as a person-centred therapist . . . citing the way in which Rogers’ core conditions to therapeutic practice are described.
Table 1: Homeopathy and PCA Similarities (‘RCC’ =s ‘Rogers’ Core Condition’)
Recognizes RCC1: client-practitioner psychological contact
RCC2: Client vulnerability: usually the thing(s) which bring the patient to the homeopath.
Does not rely on orthodox diagnostic classification systems
Does not rely on orthodox diagnostic classification systems
Approach uniquely adapted to each individual patient
Approach uniquely adapted to each individual patient
Patient-Centred, takes cues (begins with the) from patient
Client-Centred (begins with client)
Minimal Approach on part of practitioner
Minimal Approach on part of practitioner
Accurate representation of patient story
Accurate staying / being with client
Awareness of patient’s frames of reference
Uses client’s internal frames of reference
Uses tentative understanding of patient’s own descriptive language to get closer to understanding
uses mirroring, paraphrase, summary, checking out
RCC4: Unprejudiced Observer
RCC4: Unconditional Positive Regard
Encourages practitioner self-awareness
Demands Therapist Self-Awareness
RCC5: Recognizes and uses empathic processes (of both patient and remedy state)
RCC5: Empathic processes central
Aims for optimal functioning, relying on internal resources.
Self-actualization, ‘it is the client who knows . . ‘
Therapeutic effects removed from practitioner specific intention to . . .
therapeutic effects produced when the therapist is free of specific intentions to (Brodley 1998)
Vital Force (‘the dynamis’)
Central delusions (Sankaran 1991)
Barriers to change or suppressions
Conditions of Worth
Exploring remedy and relationship effects through non-local systems
Exploring ideas of non-linear dynamic systems
Recognizes holistic patterns of function and dysfunction
Witnesses holistic patterns
Provides mirroring / self-recognition via energetic stimulus
Enables mirroring / self-recognition / acceptance of client condition
VF stimulation to effect actualization: “higher purposes of our existence”
PCA therapy creates climate / conditions where self-actualization enabled
Proving methodology realizes blueprint potential of any substance
The relationship enables acceptance of patterns-of-self
which in their various potencies
address holistic patterns of the Physical – Mental – Emotional – Spiritual dimensions.
what would you say about this area ? Presumably the quality of therapist-client relationship realizable has within it the idea of different levels of quality.
Proving methodology realizes blueprint potential of any substance
The relationship enables acceptance of patterns-of-self
which in their various potencies
address holistic patterns of the Physical – Mental – Emotional – Spiritual dimensions.
what would you say about this area ? Presumably the quality of therapist-client relationship realizable has within it the idea of different levels of quality.
Uses relationship to facilitate expert choice of homeopathic remedy
Focus is on relationship: Practitioner expert in self and relationship
Treats with Homeopathic Medicine (and the relationship ?)
Mediated through relationship
Has predictive and analytic maps (Miasms, Hering’s Law of Cure, Group Classification Systems) with which to judge patient movement.
also contains predictive maps.
RCC3: Therapist Congruence
RCC6: Client Perception
Similarities which I’ll summarize as lying in:
How each discipline regards, and is regarded by the outside world.
The way in which both depart from an orthodox, reductionist medical model which concentrates on diagnostic ability and local symptoms.
The importance that vitalism /or self-actualisation hold for us.
The primacy given to each client’s narrating of her own story to
An unprejudiced observer (offering UPR) who can
through active listening, mirroring, checking out / reflecting back, and empathic
(? shamanic) processes,
work with / at the edge of awareness whilst
equally valuing all configurations of self (symptom pattern matching) at the same time
being true to and aware of own self (congruence, self-awareness)
in other words, acknowledging
The importance of the therapeutic relationship.
Both disciplines have endured challenging times, falling in and out of fashion, subject to the demands and misrepresentations of the evidence-based brigades. Both share the tension that exists between an holistic view of the individual and the prevalent medical model [Benjamin (2011), Ferris, Johannes & Townsend (2011), Johannes, 2009, White (2000, 2009)] and a desire to avoid diagnostic symptom-based labels. Both address the whole person rather than local symptomatology.
Our approaches are grounded in vitalistic (Schmidt 2010), humanistic and transpersonal world-views, with Hahnemann and Rogers being simply decades ahead of their times in the ways in which they thought about humanity and the human being. Whilst homeopathy talks about the vital force and PCA the formative tendency and self-actualisation, the writings of Roberts (1982) a homeopath living in the 1930s reveals the subtlety of such vitalistic thought:
the influence of this vital force on the whole organism is so delicately adjusted and so intimately connected with every part, that seemingly distant organs or unrelated symptoms show the effects of any distortion of the vital force and no one can prophesy what the influence may be on the part of the economy or what direction will be taken by the manifestations in each individual, but his vital force will direct the course with unerring precision
As I said elsewhere, (Townsend, 2002:82) “Homeopaths would be extremely comfortable with the parallel between the vital force and an actualising tendency which: ‘functions as long as the person is alive. The moment by moment living — the moving, responding, maintaining of wholeness, feeling, thinking’, striving — [which] are all manifestations of the actualising tendency’ (Bozarth and Brodley, 1991, p. 46). We would also resonate with the idea of organismic functioning described by Seeman (1984) as:’ intended to suggest a pervasive phenomenon that includes all of a person’s behavioural subsystems: biochemical, physiological, perceptual, cognitive, and interpersonal’ (p. 146).”
Talking with the 90-year old Jerold Bozarth this summer, I was staggered to hear him talk of the need to base his (person-centred) practice on ‘the 3-legged stool’. Now this wasn’t the ‘3-legged stool’ I learnt about as a student homeopath – but the similarity of concept amazed me.
In essence, both disciplines are thoroughly rooted in individual experience, and in the witnessing of that individual’s narrative, establishing any context within the meaning of the person reporting it, a fact as well-known to Hahnemann (see, e.g., Silvestri, 2010) as it was to Rogers. The homeopath ‘accepts’ (notices, evokes, records) the bio-psycho-social- spiritual ‘symptoms’ in the emerging picture of the patient in a way which (initially at least) values all symptoms equally – a sort of welcoming of the different configurations of self present in the patient; and pattern-matches them to a homeopathic remedy which equally holds those potentially unfolding configurations: I suppose, in your context, the act of therapeutically holding and prizing those configurations: in my (homeopathic) language, the multitude of possibilities of potential health and pathologies present in an individual proving.
Writing in the British Journal of Homeopathy (one of homeopath’s longest-established and respected professional Journals) on the nature of the psychological factors involved in homeopathic therapy in 1979, the homeopath R J Withers commented
“If the practitioner is able to “see” his patient clearly, it is likely furthermore that his vision will be imparted to the patient during succeeding therapeutic sessions.”
Furthermore, the homeopaths’ act of and art in listening to patient narrative holds within it the possibility of empathic awareness (Fraser, 2003; Kuipers, 2008; Mercer, Reilly, Watt, 2001, 2002; Thompson & Weiss, 2006) and the ability to work with an edge of awareness which parallels counsellors’ use of it, almost as if one is helping the individual before us become a participatory witness to their own existing, hidden, and emergent potentials of self. As the world-famous Greek homeopath George Vithoulkas says, a process which enables us to “crawl into the context of each patient” (Vithoulkas 1986:173).
All this, of course, is driven by the ability to actively listen, the attempt to understand, the offering of UPR – that struggling with putting our own self and judgments to one side in the therapeutic process, in the words of Jayesh Shah (2010), doing the minimum necessary to clearly be in that space with our patients:
When you are absent you are not doing.
No expectation – absence is absence.
No pre-conditioned expectations.
Absence is about going into consciousness.
Don’t judge a person – everyone should have a chance.
Shah (2010) in Heffer (2011:10)
The Importance of Self-awareness
Increasingly, homeopaths are rediscovering something that counsellors take for granted – the importance of practitioner self-awareness, and in the rediscovery surprising themselves with it’s history.
In 1983 the medical homeopath G.S. Hehr explored Hahnemann’s (1829) instructions to practitioners to become self-aware, “… by such noteworthy observations on himself he – the physician – will be brought to understand his own sensations, his mode of thinking and his disposition . . . .” (Hehr, 1983:91-92). Hehr showed how Hahnemann’s instructions dropped out of homeopathic awareness in subsequent works and commentaries and remained largely unrepresented in other major homeopathic texts of the C19th & C20th.
In fact he (ibid:92) suggests that Hahnemann’s letters of 1826 reveal he was perfectly aware of what we would now call reflective practice. The technique, he says . . .
“It is rather simple, so simple that one is tempted not to follow it. All that one has to do is to watch one’s own sensations, inclination, thoughts, emotions and desires – without taking any action, even a mental one – just observation and nothing more !”
The hugely influential American homeopath, James Tyler Kent practiced around the turn of the last century in Missouri, Philadelphia, and Illinois. He became Dean and Professor of Materia Medica in Chicago, where he worked in a number of medical colleges and he wrote, in a set of lectures on homeopathic philosophy that are, to the homeopathic community as important and relevant as anything Rogers wrote to the PCA community, and still used today
“To know the human heart well is largely to examine into oneself and ascertain what one’s own impulses are, what one is compelled to do under varying circumstances, what impulses one has to control in oneself in order to become a man… In time the physician who does this will become so well acquainted with the human heart that he has sympathy and knows what constitutes the language of the affections.”
Contemporary practitioners (e.g. Brown 2006; Evans 2010; Gray 2009; Dhawale 1994; Scholten 2008) show their growing appreciation for the subtleties of reflective practice in admitting “Self first, Therapeutic relationship next, and Remedy after that.” (Evans 2010; Gray 2009.)
“Accepting that we don’t understand what patients are telling us is, surprisingly, the most difficult aspect of homeopathic case-taking. The drive to insert our own thread of meaning into others’ words is so deep and so unconscious that it takes a very active and awake consciousness to step back and observe. The illusion of understanding is as habitual as it is comforting. When we are able to suspend this illusion of understanding, we will feel both the thrill of embarking upon a true adventure as well as the terror of unfamiliar terrain.”
As Hanson recommends in the summary to her doctoral thesis, we need to take on board
“. . . . the wisdom of Dhawale (1994) whose advice regarding the homoeopathic interview is like pure gold – sometimes to become a better homoeopath, it is wise to take time to become a better person.”
Dhawale, cited in Hanson (2010:14)
Development of the therapeutic relationship
It is becoming increasingly obvious that the relevance of the therapeutic relationship is finally coming into public homeopathic consciousness. (Gray 2010, Kessler 2010, Levy 2010, Owen 2007a &b, Reilly 2001, Thompson & Thompson 2009). Other writers (Bellavite 2011, Golden 2007, Johannes et al. 2009, Sommerbeck 2005) have gone on to make links between the relationship as it is viewed in homeopathy and psychotherapy with chaos theory and non-local events – but that really is outside the scope of this paper.
However, it is possible that our rediscovery of the humanity within homeopathy might impact on orthodox medical training itself. In a report on an elective experience, UK medical students discovered
“I had no personal experience of homeopathic medicine and wasn’t sure whether I believed in it. I can safely say now that I do. It takes a person in their entirety and respects and appreciates the individuality of humankind, which is lost or disregarded in so much of modern conventional medical practice today.” [Lorna, 2006]
“. . . . the case taking was wonderful, its patient led, and I love the fact that the patient’s feelings, thoughts and outlooks are held with such importance. I really hope to encompass the holistic way of case taking in to my own skills when I return to my placements in September.” [Cassy, 2007]
in Thompson & Thompson (2009:111)
Duckworth’s forthcoming (2014) PhD thesis will report a similar impact within conventional midwifery experience.
The Mumbai School
There have been many influential developments within the discipline of homeopathy over the last 30 years (Gray 2010). Whilst some of them (Reves 1993), Sherr (1994) have considered the importance of ‘getting the patients’ story’, it is the Indian doctor, Rajan Sankaran and his colleagues (forming what is known in our community as the ‘Mumbai School’ ) who have promoted a form of case-taking which, in endeavoring to strike deeply into the patient’s state, borrows hugely from humanistic psychology (and especially the work of Gendlin 1974, 1981, 1996, 2003), without often publicly acknowledging that debt in print (Gray 2009; Greenland 2011; Sankaran 2004, 2007):
“. . . with Sankaran (1991 and 1994), while frustrated that he seemed to be taking all of the credit for having discovered the unconscious, it was refreshing to see a homoeopath write about the relationship so lucidly.”
“Sankaran does not reference his work and implies it is original . . . from practical work . . . he makes no reference to any particular influence except The Organon, Boenninghausen and a few other homoeopaths, certainly not Rogers, Freud or Jung”
More than twenty years in development, the Mumbai School’s work in refining and developing theoretical and personal awareness of key processes which counsellors would immediately recognize cannot be underestimated and Sankaran’s “Sensation Method” is sweeping the homeopathic community, carrying with it a missed opportunity to ground this work within our own history but also place it in a wider context.
Schlingensiepen-Brysch (2006) indicates that in his original German writings, Hahnemann’s use of the word ‘focus’, was not far removed from Gendlin’s. Gendlin a student, and then a contemporary of Carl Rogers, developed a method of focusing on sensation in discrete body parts, which led to the development of the entire movement of experiential counselling. He identified the central process in this as developing an awareness of and communication with something he termed ‘felt-sense’).
Sankaran (2007:13) clearly describes his own awareness of felt-sense, the account continues with patient felt-sense work, what he describes as working with sensation. Others’ reports of his work mention the elements of empathic awareness (Muckenheim, 2007), and indeed his colleague Dinesh Chauhan’s work shows practitioner empathy and focusing elements. The latter’s (2006) article is titled Internal Focusing – to Explore The Vital Sensation.
In this and a later article (Chauhan, 2007) the author shows how homeopathy has rediscovered experiential psychology, in the way in which
“ . . . the patient can pay attention to his/her inner self, and the inner experiences which can be felt in his/her body. It is a way to concentrate internally so that the patient can go beyond the mind and the body and will be able to focus on what lies beyond the mind and body. I call it an internal focusing technique.”
Whilst Indian homeopathy does not recognize it’s debt to humanistic psychology, such working with edge-of-awareness somatic-sensory material has been conversationally acknowledged to derive from Gendlin’s (1981) work (Greenland, 2011; Leirs 2011). One hopes that Gendlin’s own comment ‘As long as we use these procedures or knowledge only as tools, only as ‘fishing lines, not fish’ is heeded. [see Gendlin, 1974:243 in Lietaer (1998:71), also Gray 2010:9]
In a recent book, the Scottish homeopath and teacher Margaret Roy produces a series of clinical notes on the homeopathic interview, drawn from her extensive 30+ year career, and advises:
‘our starting point is always to put the patient in touch with their own process, their own body even.”
Roy, 2011 (Lesson. 6)
acknowledging the work of Gendlin
“However, Eugene Gendlin noted that much psychotherapy was ineffective and on studying different situations he identified a process that took place in effective therapy. He called it focusing. Even if you cannot get your patient to do this (it may not be appropriate in a homeopathic interview) I recommend you learn to do it yourself to enhance your awareness of any situation and as a technique that will link your inner and outer experience.”
Ibid (Lesson. 7)
Roy is one of the first homeopaths to publically acknowledge this in print, and indeed she includes a summary of Gendlin’s 6-step process drawn from his 1981 book.
Other ‘rediscoverers’ of focusing do pay credit to its forbears. Isabelle Leirs studied focusing and client-centred therapy in Belgium where she graduated in 2003 as a clinical psychologist and then worked for 5 years as a psychologist whilst also studying homeopathy. With her clinical background she was able to make the links between homeopathy and the person-centred approach inherent in the publications of the Mumbai School and she continues to write about some of these. (Leirs 2008, 2010, 2011).
Ildiko Ran, a psychologist and homeopath from Massachusetts now living in California and working on her Master’s thesis (Psychology) at San Francisco State University, is investigating aspects of counseling skills that we use in homeopathy. She also works with the Sensation method as well as Focusing-oriented psychotherapy (Ran & Menyhert 2007, Ran 2009a-e, 2010, 2011) and freely acknowledges the contribution of person-centred therapy to homeopathy:
“The big difference between the Sensation method and Focusing is that Gendlin does not look for a vital sensation, he considers all bodily felt senses separate from each other . . . he also does not have the wonderful comprehensive map that Sankaran has conceptualised . . . . BUT he has the refined way to find it in the person with the participation of the client, which is badly missing for me in Sankaran’s work. I believe that the client should do the work and be part of the process, not just the clinician. In fact, psychotherapy has the process so much more as a central issue than homeopathy.”. .
The Boston pyschologist-turned-homepath, Dr. Lorreta Butehorn, in commenting on the shamanic aspects of Sankaran’s practice and comparing them to Hahnemann’s original writings, uses language with which I think, as person-centred therapists, we would be quite comfortable:
“This is the aspect of case-receiving that Sankaran has refined. By observing and fully accepting all that is being observed, within the entire biofield of the patient-practitioner; by staying with the patient in all his / her expressions, and by following the body language of the total organism into the experienced sensations, always asking the patient to reveal in human language its essential nature, one receives the full homeopathic case true to Hahnemann and true to the nature of the patient with all his/her relationship to Nature itself.”
Homeopathy & Psychotherapy working together
It appears there is a burgeoning literature that recognizes that our two approaches share historic parallels, similar concepts, and practical ways of being with clients.
Johannes & McNeill (2005)
In 2005, these two authors drew from the experience of integrating counseling / psychotherapy into their own practice of homeopathy, commenting that
“The vast field of counselling and psychotherapy has a number of somatic-energy based (e.g. Reichian, Holotropic), existential, transpersonal and traditional therapies (like Gestalt therapy) that could potentially blend very well with homeopathy.”
Johannes & McNeill (2005:52)
They pointed out that
“One of the finest and most notable homeopaths of the last century, Dr Edward Whitmont . . . brilliantly combined homeopathy with counselling and Jungian analysis.”
and debated the creation of additional certification as a ‘Homeopathic Counsellor’ (a proposal which has yet to attract support). In The Homeopathic Counsellor – Beyond the Remedy Johannes continues to expand the case for creating a closer and more formal integration between our two disciplines (Johannes 2010). See also Townsend, Johannes & Ferris (2011).
In addition to the links to the PCA running through our homeopathic literature, there is another strand (not considered here) representing homeopathy’s awareness of Jungian and transpersonal psychologies. Whilst Benor and van Hootegem (see below) talk about the transformative power of homeopathic treatment, Johannes et al. have produced a detailed analysis of the parallels between homeopathy and transpersonal psychology (Johannes, van der Zee, Lindgren (2009:128), with Barzman (2010) being the most recent contributor to this debate.
These authors indicate that there could be a benefit to be gained from a wider acknowledgment of these links. A widespread anecdote in homeopathic circles is of the patient coming to us who remarks, at the end of a lengthy case interview, “you know, I’ve never told anybody that before.”
This holds true, seemingly, for patients familiar with many different forms of psychotherapy. The other anecdote is of the patient who has ‘held’ therapeutic issues unresolved for long periods of time, seemingly to have them dissolved rapidly by homeopathic treatment.
Perhaps a personal story might illustrate this here ? I well remember the client who came to me for treatment for anxiety, in the course of which was revealed a decades-long history of self-abuse involving the cutting and scarification of the arms. Abuse which was currently ongoing, and evident. A couple of days after the patient received homeopathic treatment (and remember, that’s one dose of one pill . . .) I took a phone call at home. “Townsend, what have you done to me ?”
It transpired that our patient was – surprised would be too mild a term for it – astonished that the impulse-to-harm which had been part of their life-background for so long had completely disappeared. I followed the patient’s story for a few more years, and that impulse never returned.
The Canadian-based psychiatrist, Daniel Benor, studied psychiatry at a time when it’s primary focus was psychotherapy rather than psychopharmacology. (Benor, 2005, 2008). He is now discovering that certain alternative approaches to health (Benor 2004, 2006, 2007) can potentiate the impact of the therapeutic interview. He has this to say about homeopathy:
Homeopathy offers profoundly transformative changes, and often with startling rapidity, when a remedy is found that resonates with the person’s situation.
(Benor, 2004, cited in Johannes & McNeill, 2004:48)
Merizalde’s (2008) article carries a literature review of clinical studies and case reports documenting the efficacy of homeopathy in the treatment of various psychiatric disorders. It reports the remarkable convergence of the symptoms of many homeopathic remedies and the characteristics of many modern psychiatric clinical syndromes, giving examples.
The Belgium doctor and homeopath Van Hootegem graduated as a general physician in 1982. He tells me “from the beginning of my practice, I was interested in homeopathy . . . in the course of my homeopathic practice, I became more and more aware of the importance of the therapeutic relationship.” (Van Hootegem 2011)
In a detailed case study (Van Hootegem 2007), he discusses the importance of the working alliance (from a psychodynamic point of view) and its impact on positive therapeutic outcomes. He describes the process by which both therapeutic exploration and homeopathic remedy action connect dynamically and differentiates between the impact of each element. He further states: “In my current practice, I frequently combine homeopathy with methods and insights from psychoanalysis. One approach complements the other.” (Van Hootegem 2011)
Perhaps the most compelling description of how our two approaches might be combined is found in a 1992 article where the South American doctor and therapist, Risquez provides us with a very detailed (almost a verbatim transcript) case study.
Dr. Jane Ferris, a depth psychologist working out of San Francisco, interviewed 13 therapists for her doctoral dissertation, and commented:
‘Many of the (psycho-) therapists value the mutually beneficial relationship they have with homeopaths who work with their patients.”
discovering that her interviewees valued the relationship they had with homeopaths:
“I am always fascinated that she can get to basic information that I wasn’t able to obtain as a therapist after 3 or 4 years. It is often about substance abuse or something pretty significant that didn’t come out . . She found out something important about almost every client.”
My paper started by suggesting that the Person-Centred Approach provides a body of knowledge and skills which can easily be related to homeopathic practice. It demonstrated that a rudimentary awareness of each discipline existed in the other from their very beginnings, and proposed a similarity of concept and philosophical approach that sit well together.
The idea is advanced that not only can psychotherapists gain from being aware of the power of the homeopathic approach and perhaps considering working with homeopaths from time to time, but also that, when appropriately explored by homeopaths at both undergraduate and post-graduate level, they respond enthusiastically, readily recognizing and incorporating its ideas to their own practice.
It suggests (as Ferris’ 2009 research points out) that there are elements of our therapeutic consultation – a lack of understanding about the holding, relational aspects of therapy (Ferris 2011) which need addressing by our profession if homeopaths are to move their relationship skills from more than an instinctive level and begin to approach the homeopathic-counselling role envisaged by Johannes (2010).
“It is a startling and beautiful fact that powerful resonances exist between substances in nature and the interior of the human psyche, and that these resonances are capable of initiating healing and facilitating individuation.”
Barzman, A. J. (2010) Closer Than They Appear: Homeopathy, Analysis, and the Unus Mundus, Paper delivered 26 August 2010 at the XVIIIth Congress of the IAAP Facing Multiplicity Psyche Nature Culture. [online] available at URL: http://www.hahnemanninstituut.nl/pdf/Homeopathy_Analysis_Unus_Mundus_Barzman_2010_IAAP.pdf [last accessed 19-03-2011]
Bell, I. R., Lewis, D. A., Lewis, S. E., Brooks, A. J., Schwartz, J. E., Baldwin, C.M. (2004) Strength of Vital Force in Classical Homeopathy: Bio-Psycho-Social-Spiritual Correlates Within a Complex Systems Context. The Journal Of Alternative And Complementary Medicine, Vol. 10, No. 1:123-131.
Bell, I.R. (2006) The Homeopathic Universe: Disease and Healing as Manifestations of Consciousness. SHIFT: At The Frontiers Of Consciousness, No. 10, pp. 22-26. [Online], available from Institute of Noetic Sciences, at URL: http://noetic.org/library/publication-articles/homeopathic-universe/ [last accessed 28/01/2011].
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About the author
At the time of writing the original paper, Ian Townsend had been Senior Lecturer in the Division of Complementary Medicine at the University of Central Lancashire’s School of Health since 1998. A member of the multi-disciplinary team of homeopaths, herbalists, aromatherapists and massage therapists who comprised the Integrated Healthcare Unit, he had close links with the Division of Counselling and Psychological Therapies (he gained his postgraduate Diploma in Professional Counselling there in 2004); during the previous decade he focused on developing two undergraduate modules: Communication and Caring in the Patient-Practitioner Relationship and Developing the Therapeutic Relationship.
A lifelong teacher (he is a Fellow of the UKs’ Higher Education Academy), he was introduced to the person-centered approach in the 1960s. Becoming fascinated with the humanistic psychology movement, he trained with John Heron at the Institute for the Development of Human Potential, explored Assertiveness Training and sexuality with Anne Dixon, rebirthing with Frank Lake, and transpersonal approaches with Ian Gordon-Brown and Barbara Somers, and Diane Whitmore. He was introduced to the person-centred approach by Donald Anders-Richards, a pastoral counselor and educationist who in the late 1960s / early 1970s had been both a participant in and staff facilitator of encounter groups in California at the Institute where Carl Rogers was consultant.
A decade-long involvement in a radical countercultural psychiatric movement (co-counselling: Jackins, 1975) showed him the value of patience, of silence, of listening-without-interrupting; and of how humans could experience, manage, and survive in the face of the widest and wildest possible range of mental health pathologies. The 1980s saw him training as a homeopath, working for 25 years as an independent homeopath; along the way collecting certification in clinical supervision, person-centred counseling, person-centred group facilitation and person-centred supervision. For some of that time he was the profession’s first employed Professional Conduct Officer.
In 2011 he was granted a lifetime Honorary Fellowship of the Society of Homeopaths, an award made to recognize “. . . outstanding and positive contribution and service to homeopathy . . . positive impact on homeopathy teaching and practice” [http://www.homeopathy-soh.org/about-the-society/fellow.aspx]
Ian taught at many of the UK’s private Colleges and Schools of Homeopathy and course-led both BSc and MSc homeopathy programs at university level. Between 2005 and 2010 he concentrated on writing and delivering MSc modules on Therapeutic Relationships and Person-centred Supervision and exploring the links between the person-centred approach and homeopathy (Townsend 2002, 2004a, 2009, 2010). He retired from homeopathic teaching and practice in 2011, since which time he has taught person-centred practice on a foundation / BA (Hons) Degree in Counselling at Blackburn College, Lancashire. He is a member of the British Association for the Person-Centred Approach and the American-based Association for the Development of the Person-Centered Approach.
Nice article, but what about people who get hurt by the depth interviews conducted by homeopaths?
“A widespread anecdote in homeopathic circles is of the patient coming to us who remarks, at the end of a lengthy case interview, “you know, I’ve never told anybody that before.”
I know about two cases, where the patient went to a homeopath, the homeopath made the patient speak about a lot of traumas, associated deep emotions, feelings, and then the patient got in a bad state. Not just for weeks, but for months. In both cases the homeopaths did not take any responsability, they did not even really care.
It has been known for several years between trauma informed professionals, that just retelling traumas might be re-traumatizing. Homeopaths shoud be aware of this, and work accordingly.
Also, the other problem is that this kind of emotional “opening” of the patient can create a very powerful attachment/transference to the homeopath. I cannot give you a literature link to this, but this is what a psychotherapist with more then 2 decades of experience has told me. The big problem with this is that the attachment/transference is not treated professionally, since most of the homeopaths are not psychotherapists, and homeopaths usually meet with their patients every 1-2 months. So actually the patient is abandoned by the homeopath in such cases, since the patient has to manage this strong attachment/transference alone – this would never happen in a professional/ethical psychotherapy.
Thanks for your comment.
I am afraid this is not correct.
The aim of the homeopathic consultation is to identify the patient symptomatology. The symptoms presented at the time of the consultation. No homeopath ‘makes the patient speak’ about his or her traumas unless they want to. Patients are never made to ‘re-tell’ their traumatic experiences, they need to speak of their symptoms. In the event that a patient will seek to speak of his or her trauma, they are never left alone. The description of a traumatic event only explains the cause of symptoms of their pathology for which they are seeking treatment. The carefully selected treatment meets the symptom picture presented by the patient.
Patients seeking homeopathic treatment should go back for follow up treatments. One single consultation will not resolve a deep seated complaint. All homeopaths generally provide access to their care in the interim, should the patient require acute assistance or have queries concerning their treatment.
Transference happens in all spheres of the medical profession. This is not an effect of homeopathic practice alone. With a successful treatment the patients reliance on the practitioner will be dissipated as the pathology is treated. Patients are never abandoned. Transference is very common in psychotherapy due to the exploration into past trauma. This, as mentioned above is, is less so the case in a homeopathic consultation.