Abstract: Love is perceived differently in both genders and it’s a cliché that women seek emotional support and men seek physical satisfaction. But by middle age both male and female who are in the same age group, have great hormonal turmoil and as a rule display their love and emotional needs as well as how they achieve it, differently. This case report is one such saga analysed neutrally.
Take away points: As a homeopath we need to do all that is essential for the holistic wellbeing of our patients and one such thing is knowing what is normal and knowledge of deviations thereof. Cure is a state of harmony and totally individualistic, which we are just here to assist them to achieve.
Menopause or perimenopause and its implications
Premature ovarian failure is defined as menopause before the age of 40 years. It may be idiopathic or associated with toxic exposure, chromosomal abnormality, or autoimmune disorder.
Symptoms are sociocultural and family factors are more important in the aetiology of mental illness in menopausal women than physiological changes. Anxiety and depression in such women do not respond to oestrogen therapy, although some cases respond to antidepressants. (1)
Introduction: Sternberg (1986) asserts that a healthy relationship will have all three components of love; intimacy, passion, and commitment which is expounded as consummate love.(2) University of Pennsylvania neuroscientist Dr Ruben Gur says that in the similar fashion men and women have different bodies, they have different brains as well as distinct wiring. (3)Women more often follow feminine display rules, and suppress negative emotions and show positive emotions. Contrary to this men have masculine display rules, by suppressing positive emotions and the show negative ones. (4)
With this background if we explore this case report I think we can get to the point of the turbulence of emotions and relationship issues revealed here.
Mrs.sagarika(name changed), aged 41 consulted me on1st Dec 2016.
Amenorrhea for the past 4 years with only spotting during menstruation. Had profuse white discharge for the past ten days.
She has left knee joint pain since 4 years aggravated by hormone replacement therapy given for her early menopause.
Appetite- less, sleep disturbed due to thoughts and old hurt, constipation.
Rx Ignatia amara 30 for her OD \3 days was prescribed.
This couple were referred to me, by their friend as they both were on the verge of separation after 20 years of married life. I started it as a casual conversation so that it matures to a dialogue but before that she vented out all her anguish, telling me I can’t live with him. So the fight started right in front of me, in my consulting room and it was repeated for several weeks. Indeed I was apprehensive to give appointment to them as they gave no heed to my time or upheld any etiquette. I was losing hope of helping them.
16\12\16 she’s in an aggravated state in all planes her old hurt coming to surface, anger towards her husband as well as the system, cried when attending a marriage function, as she felt sorry for the bride who supposedly is walking into the trap.
She feels at times should take revenge on him or to hit someone or just to escape from all of these troubles. Similar issues she suffered 15 years back when she came to know about her husband’s past life. Pulsatilla 6c was prescribed for knee pain which got << before menses << on first motion and for Pre Menstrual Stress (PMS).
Remedies prescribed for her: Ignitia 30 was given based on disappointed love, hysterical behaviour, but it had little impact, Natrum mur 1M of no help based on consolation aggravates. Then analysing aversion to husband, other tendencies such as well dressed, loquacious, prescribed Lachesis 200 but it aggravated badly.
After thorough analysis complaints similar to Lachesis but more of nervous system origin, feels neglected 3+, I prescribed Naja 1M OD/ weekly dose. It brought about much relief in all aspects; her left sided headaches reduced, burning and irritation during urination reduced, anger could be controlled. Staphysagria 30 was prescribed previously but had not helped.
Remedies for him: Nux vomica 30 was first prescription as he was abusive, he needs to be in control and dictatorial. Then he had a severe bout of dizziness and angina like symptoms especially during mid of the nights, so Digitalis 6c was given, but it didn’t help. He had numbness of the left arm, dyspnoea; he woke up suffocating, gasping, choking, he had 2 to 3 such episodes. Naja 30 OD \ 3 days relieved him. His final prescription was Androctonus 30 for his desire to hit, use bad language, similar to Sulphur but more profound (5). He didn’t take any treatment further from Dec 2016, claims he is healthy but regularly comes to take medicines for his wife’s sake.
Crux of the case: She suspected infidelity from her husband based on past happenings and that he hides his phone as well as gets mad if his WhatsApp is checked by her. But he claims he is helping out the lady in question who had very difficult life situations, as her parents had helped him in his struggling years.
They have created a vicious cycle. She degrades him, he gets angry, he degrades her mother then a fight erupts, it continues, he hits her and she resigns. But he needs her, she refuses and stays upstairs with her son.
Counselling sessions we planned separate with both of them and usually together sessions were ending in fights. So, they were left to settle scores at home and just attend sessions separately in my clinic.
It was a great surge of emotions for the therapist as well on hearing her ordeals felt sad and spent sleepless nights thinking of the plight of oriental women, how they endure everything for the sake of their families.
But Homeopathic medicines brought out subtle changes in both of them. So, medicine acting in the background, psychotherapy in the forefront, the paradigm shifted.
Cognitive behavioural therapy was adapted accordingly.
Sessions with her:
Cognitive therapy: I challenged her negative emotions. She admitted it’s been, thinking about past events and digging for more hurt as well as validating her acts by analysing his each act. Stress is increasing paramount.
Behaviour therapy: I asked what could be done to change the scenario, she composed herself and said yes I need to come out of this problem and she worked on it as we both discussed a few ideas.
Need to focus on mental wellbeing and imaginary problems need to be avoided, keep it real and make it practical.
To stop overgeneralizations of past happenings as well as present.
Directly talking to the lady in question but without bias.
Preventing ugly confrontations with him and talking only to the point.
Believing to some extent what he says.
Solution based view of the issue rather than problem focussed.
I asked her to take charge of the situation,
Not to burden her son’s future when he is forced to care for her but he’s in no mood to do so because of his own family.
Further, I pointed out to her what he has been doing in a subtle way, he is not an alcoholic like his father, (it was relevant so this point was raised) nor he has other bad habits, he has encouraged her to become an entrepreneur and helped her succeed as she could buy a car with the earnings. He sent her to all the courses and meditation classes she wanted to attend. So, she has to draw inferences from those acts of him. Further I encouraged her to read books like “Men are from Mars…”
Sessions with him: His was a vent of emotions and as a man, he said he had endured much for his family as his wife as she is not as expected. He compensates her inadequacies by completing chores, protecting from his parents wrath etc.
I didn’t involve him in CBT as he is responding to her acts, he is struggling to retain harmony but in a way which can lead to more damage, but believes this is the only way. (for example hitting her, abusing her mother, blocking her favourite pursuits)
I suggested to him physically abusing wife is never a brave act and cannot be justified in any way. He needs to stop overgeneralizations of past or present happenings and talking only to the point. He also should work with a solution based view of the issue rather than problem focussed one.
I spoke to their son separately and he voiced difficulty in taking sides though mother expects total support and to disown his father. He had no problems in his relationship with this father, so it’s tough to hate for his mother’s sake. Although he wants to slowly move out of the scenario to guard his own mental peace.
By March 2017 that is two and half to 3 months’ time these sessions were done and they stopped coming to me abruptly. I thought they would have got divorced. Again in June 2018 I heard from them as she had few issues. Again her menstruation had reduced which was flow for a day after treatment with Naja 1M followed by Natrum Salicylatum 30 to restore suppressed menses in perimenopause women. Her TSH was high again and prediabetes was added on. Slight come back of the mental symptoms. I was happy to note that they had resolved their conflicts amidst negotiations by family and well-wishers. They stayed together but both didn’t elaborate much. Yes, husband and wife need to talk to each other and not about each other. Am treating her physical ailments still on and off but few points never came up like the word “divorce”.
I can say they are coping well.
Discussion: As a mental health professional one can see there’s a difference between Major Depressive Disorder and menopausal depression, which is not just a thing that can be overcome by will or by improvement in circumstances; but so to say deep rooted and miasmatic in nature. It needs psycho- social interventions along with guided Homoeopathic treatment. But often the right remedy brings reaction as there’s a difference between MDD and menopause triggered major episodes.
Her emotions, thoughts and disgust for certain happenings as well as hurt is all true, yet if we examine why it is surfacing now though she says generalizing it’s been the same throughout. It seems her hormonal alterations triggered most of the issues and peaked due to circumstances.
She does meditation and has no interest in household work and family affairs at times. I asked her to reassess if it’s due to meditation or the other way round and, if because of meditation to reconsider her priorities, since she’s just in her forties. She took my advice and stopped getting advanced meditation practices. Her work is adjustable and fulfilling. She rearranged her priorities.
Role of homeopathy: I believe as well as observed that homeopathy can bring about clarity in thinking, reduces negative emotions like disgust or malice as well as improves serenity along with physical wellbeing. When both of them went into a similar scenario which had led to their referral to me in the first place; outcome was different. It’s mutual and not forced upon I believe yet some ‘let go’ has happened.
Besides it’s a great learning, insightful and deep reflection for me as a homeopath who has to deal with my emotions as well as has to battle compassion fatigue. Of Course homeopathy is there for my rescue.
References and acknowledgements.
1.Kulkarni, J., Gavrilidis, E., Hudaib, AR. et al. Development and validation of a new rating scale for perimenopausal depression—the Meno-D. Transl Psychiatry 8, 123 (2018). https://doi.org/10.1038/s41398-018-0172-0
4.Simpson, P. A., & Stroh, L. K. (2004). Gender Differences: Emotional Expression and Feelings of Personal Inauthenticity. Journal of Applied Psychology, 89(4), 715–721. https://doi.org/10.1037/0021-9010.89.4.715
Was part of conducting national webinar series of IHMA “Illuminare” 2020 Conducted ten webinars for her compiled book ‘Essentials in case approach and management of ASD with Homeopathy’.
Presented 6 webinars.
Developed Questionnaire for Covid-19 and Telemedicine for homeopaths Presented original paper: “Evaluating Levels of Health an essential step in Cancer care- A perspective.” at International integrative Oncology conference at Kochi in 2020.
“Complementation phenomenon and law of similars” at NSRAH- in 2018 In ‘Clinical and Experimental Homeopathy’ journal, “Case report of Juvenile Myoclonic Epilepsy coped with Homoeopathy; focus during Parturition” peer reviewed article published in Jan 2017.
Was in scientific committee of “Zurek Zu den Wurzeln” the second International Conference at Torgua in 2018
Editorial board and national conference committee of Eunioa-2017.