Fear and anxiety during the pandemic: An investigation of fear and anxiety rubrics in seven remedies
Introduction and overview
This month’s theme of Clever H is fear, anxiety, guilt, and hate. Considering the pandemic times in which we are living, the topic of fear and anxiety seems highly relevant: Many have been living in and with fear this past year: fear of infection, of illness, of proximity to others, of loneliness, and, in many cases, fear of death. I will therefore bring the themes of the pandemic and of fear together and take a closer look at the fear symptoms and rubrics in some of those remedies that match the symptom picture of an acute viral infection.
By now, many homeopaths have spoken and written about such remedies. Some homeopaths, including Robin Murphy , Jeremy Sherr , Rajan Sankaran  and the Joshis  have freely shared pertinent information online. Others have published about remedies they have used (for example: Jethani et al., 2021 ; Rutten et al., 2021 ; Valeri, 2020 . While there are some differences between the remedies emphasized by the various authors, some emerge as relevant across publications. These include: Aconite, Antimonium-tart, Arsenicum, Bryonia, Gelsemium, Phosphorus, and Pulsatilla. In the following, I will explore symptoms of fear and anxiety in these selected remedies.
Aconite and Pulsatilla both belong in the family of the Ranunculaceae. Sankaran (2005, pp. 789f.) describes the remedies in this family as characterised by extreme sensitivity, highly sensitive to emotions, easily vexed and insulted, with typically two out of the three emotions of anger, fear, and grief present, while the third emotion is being suppressed. Passive reactions in this family include numbness and bluntness, whereas active reactions are characterized by nervous tensions, outbursts, and tremors. 
Homeopaths know Aconite as a remedy given in sudden, acute, and often violent states, including states of acute anxiety and fear. Clarke (2006, p. 16) describes Aconite as being characterised by extreme tension which manifests as fear: “There is emotional and “mental tension, as shown in fright or fear and its consequences, anxiety, and fear of death” . These quotes give a good sense of the intense fear state in Aconite, and they point to two additional characteristics: There is fear of death, and there is fear that can be out of proportion to the actual complaint: fear accompanying even the most trivial of ailments.
A look at the repertory (here and in the following: Complete Repertory, accessed through Complete Dynamics ) shows that Aconite appears in more than 60 fear rubrics and in a similar number of anxiety rubrics. Prominent rubrics include fear after and during vexation, at night, fear in a crowd, with heart complaints, of crossing streets, of death, of suffocation, and panic attacks; and fourth grade anxiety rubrics comprise anxiety at night, with heart complaints, with palpitations, pulsations, anxiety with difficult respiration, anxiety in the chest and heart region, and anxiety about their health, prolonged fear, fear of people, of busy streets, of touch, and anxiety in croup, anxiety about the future, and hypochondriacal anxiety (4th and 3rd degree rubrics). Among smaller rubrics are fear of going out of doors and of public places, fear in respiratory complaints, anxiety in croup, anxiety preventing breathing, constant anxiety, and anxiety about everything.
Relating this picture to the current pandemic, Aconite thus covers both the fear of the sudden, new threat, and the prolonged fear that goes along with living under pandemic conditions for what has now been more than one year. A person in the Aconite state is tense, vexed by the entire situation, intensely fearful to the point of losing one’s life, fearful about health, fearful even where this fear is not well founded (hypochondria). There is the fear of being outdoors, of public places, of the proximity of other people, of touching or being touched by others. There are also fear and anxiety related specifically to the circulatory (anxiety with heart complaints, with palpitations) and even more so to the respiratory system (anxiety with difficult respiration, preventing breathing). We can thus see the physically healthy person in an Aconite state, with constant fear of becoming infected, and the sick person in an Aconite state, with palpitations and difficulty breathing, experiencing overpowering fear of death.
I will continue here with Pulsatilla, as it also belongs to the Ranunculaceae family and is therefore characterised by the same sensitivity, the same combination of anger, fear, and grief as Aconite. But whereas Aconite belongs to the acute miasm, Sankaran (2004, p. 170) assigns Pulsatilla to the sycotic, avoidant miasm .
Like Aconite, Pulsatilla has many fears and anxieties: fear of the dark, of death, in the evening, of ghosts, insanity, and people, anxiety with palpitations, pulsations, with difficult respiration, in the heart region, and in the chest, and anxiety about health, hypochondriacal anxiety, fear of being alone, of being in a crowd, of disease, evil, suffocation, with diarrhoea, tremulous fear, anxiety about the chest and the heart region, in bed, about the future, (4th and 3rd grade rubrics). Smaller rubrics include fear of being forsaken, of public places, of being suffocated at night, of separation, of tuberculosis, fear with weeping, and constant fear, fear of everything, tremulous fear, morose anxiety about health, anxiety about health with grief, anxiety about health with weeping, and likewise anxiety about health with irritability.
Bringing these rubrics together, one can say that the Pulsatilla state during the pandemic is one of constant tremulous fear, especially fear related to disease, fear for one’s own health, grief over possibly losing one’s health. As in Aconite, there is fear of being with people, fear of crowds, and anxiety and fear relate to both the circulatory and the respiratory system. In line with the typical Pulsatilla picture of the “affectionate, mild, timid, emotional, tearful” (Vermeulen, 2004, p. 1108) personality, a person in the Pulsatilla state responds to the pandemic situation with grief, with weeping, with fear of being forsaken and being left alone .
Bryonia is another plant remedy, belonging to the family of the Violales. Core sensations of the family at the mental level according to Sankaran (2005) are an aversion to being disturbed and a sense of vexation. Passive reactions include prostration, wanting to rest, avoiding people; active reactions are irritability, restlessness, even violence and rage. The compensatory reaction would be quietness, calmness, and stillness. 
Prominent fear rubrics of Bryonia include fear of death, misfortune, suffocation, anxiety with heart complaints, palpitations, in the chest, at night, with difficult respiration, about the future, about health, and anxious restlessness (3rd and 4th grade rubrics). Small relevant rubrics in Bryonia are fear during cough, in croup, on entering a room, the desire to escape, anxiety with congestion, anxiety with thoughts, with thinking about it.
Bryonia thus also has that fear that is associated with the chest region and with respiration (fear of suffocation, during cough, in croup, anxiety with difficult respiration, with congestion – and the associated fears of entering a room, wanting to escape), mirroring the situation of a patient with stage 2 or 3 Covid19. The characteristic Bryonia state of vexation and restlessness can also be seen to manifest in the fears. The person in a Bryonia state will react to the pandemic situation with anxious thinking, thinking about the future, about possible misfortune, wanting to escape – and, if sick, will of course desire to be left alone.
Gelsemium is the fourth and last plant remedy in the above list of remedies relevant during the pandemic. It belongs in the Loganiaceae family (like Nux vomica, which has also been mentioned in the context of the pandemic, for instance by Jethani et al., 2021 ). Core sensations in this family comprise feeling shocked, shattered, ruined, disappointed. Passive reactions are a sense of paralysis and faintness; active reactions include excitability and convulsions. The compensatory reaction is one of calmness and composure (Sankaran, 2005, pp. 558f. ). Gelsemium, which Sankaran places within the sycotic miasm, is described by him as fearing the shock and thus wanting to avoid it. Most homeopaths will know Gelsemium in this avoidant context as one of the key remedies to give with anticipatory fear of examinations, with “apprehension, anticipation and timidity” at the centre of the remedy (Vermeulen, 200, p. 649 ).
Prominent fear rubrics for Gelsemium include fear of death, of falling, in heart complaints, tremulous fear, fear of being alone, that something will happen, panic attacks, of losing self-control, anxiety in heart complaints, in the heart region, with palpitations, pulsations, with anger and vexation, anxiety about the future (4th and 3rd degree rubrics). Some of the small rubrics are fear from and with diarrhoea, in public places, with palpitations, fear ameliorated by company, of lung complaints, of even a few people in public places, of being talked to, cannot speak, of the unknown, of pneumonia, anxiety in the heart region with restlessness.
As in the other plant remedies, Gelsemium thus also covers the state of fear that is associated specifically with the chest and heart region. Fear in the Gelsemium state is not as closely related to the respiratory system as it is with the previous remedies, but interestingly it features prominently in the small rubrics of fear of lung complaints and pneumonia. The Gelsemium fears are typically unspecific: intense fear as in panic attacks and tremulous fear, fear that something will happen, fear of the unknown. This contrasts with the very specific fears just mentioned that relate to the respiratory system; there is likewise a specific fear of even a few people in public places and a fear of being talked to (and being unable to speak in turn). The Gelsemium fear state can go along with anger and vexation, and a person in that Gelsemium state is – like a person in a Pulsatilla state – afraid of being alone.
Antimonium-tart is known in the homeopathic materia medica for its association with the mucous membranes and the respiratory system. Its remedy picture includes great weakness, “much secretion of mucus; […]; suffocative shortness of breath; […] Loose, coarse, rattling cough; […] chest seems full, but less and less is raised” (Vermeulen, 2004, p. 118 ). Based on its position in the periodic table, it is part of the silver series, located in column 15 that is characterised by the themes of past loss, death, surrender, handing over and sacrificing, among others. “The power has gone and they no longer keep up the façade either.” Yet at the same time “In the first instance they refuse to believe that things have really come to an end. … They may do the most desperate things to delay the end.” (Scholten, 2005, pp. 58f. ). In addition, Scholten also sees aspects of the Carbon series in the remedy, especially I, value, and body. Acccording to Scholten, Ant-t is thus close to the end, yet fights this and fights to maintain individual existence (o.c., pp. 639 ).
The remedy is also represented among the fear rubrics of the repertory, such as: fear at night, of being alone, of death, of suffocation, panic attacks, difficult respiration aggravated by fear, anxious respiration, anxiety with heart complaints, with palpitations, with pulsations, anxiety in the heart region, anxiety about the future, about one’s health (3rd and 4th grade rubrics). Small rubrics include: fear of cough, fear of death with respiratory complaints, fear of fatal disease, fear of suffocation at night, fear of medical exams, of being touched, anxiety from coughing, during cough, in pneumonia, with accelerated respiration, anxiety with asthmatic complaints, discouraged with anxiety.
The picture that emerges is of severe respiratory illness (as in stage 3 Covid-19), close to acute respiratory distress syndrome, thus reflecting Scholten’s description of a disease state close to the end, yet fighting for self-preservation. The fears are primarily related to those respiratory symptoms (also manifesting in the heart region) and to associated fears concerning a fatal outcome of the disease. In addition, a person in the Ant-t state is averse to being touched and to medical examination.
Based on its position in the periodic table, Arsenicum album is part of the Ferrum series and, interestingly, also located in column 15. The same themes of loss, surrender, closeness to the end, yet fighting for self-preservation that are described above for Ant-t thus also apply in the case of Arsenicum. In his group analysis, Scholten associates Arsenicum with the themes of redundancy, thieves, fastidiousness, being alone, restless, and with decay. In Arsenicum album, characteristics of Oxydatum are also assumed to be present, characterised by a sense of being abused and victimised (2007, pp. 507ff. ).
The remedy picture of Ars alb is so well known that this is almost superfluous, but for reasons of completeness, fear rubrics are nevertheless listed here. Prominent rubrics include fear worse at night, anxiety at night and in the evening, fear of being alone (with many subrubrics), of death (likewise with many subrubrics), of suffocation, fear and anxiety in heart complaints, of disease, of violence, anxiety from complaints, anxiety driving him from place to place, anxiety with nausea, palpitations, with difficult respiration, anxiety with sleeplessness, with weakness, anxiety of conscience, anxiety about his family, about the future, about health, oppressive anxiety, anxiety for others, sudden and paroxysmal anxiety, tremulous anxiety, anxious dreams, and anxious restlessness (4th and 3td grade rubrics). Smaller rubrics include constant fear, fear of contagious disease, anxiety before and during cough, in dyspnoea, in pneumonia, in tuberculosis, with faintness, fear of being murdered and being poisoned.
Like the other remedies that have already been described, the remedy picture of Ars also includes much fear and anxiety related to the heart and to respiration, including also many small and distinctive rubrics. In line with its position in column 15 of the periodic table, one can see fear and anxiety with weakness and with faintness, anxiety about health (both own health and that of others), fear of death, fear of disease, and fear of contagion – which has made it one of the most frequently prescribed remedies in the context of the fear of becoming infected with the Coronavirus. In addition, one can see the typical Arsenicum picture of fear of being alone, of aggravation at night, coming together in the fear of dying alone at night.
With Phosphorus, we are looking at yet another one of the best known homeopathic remedies. Phosphorus is part of the Silicium series, where relationships, family and communication are salient, and it is – like Ant-tart and Ars alb – located in column 15 of the periodic table. Core themes are therefore related to preserving and holding on to friends and relationships, yet also to losing love and relationships (Scholten, 2007 pp. 292ff. ).
Like Aconite, Gelsemium, Pulsatilla, and Arsenicum, Phosphorus is also one of the key fear remedies in the homeopathic materia medica. Prominent fear rubrics include fear and anxiety worse at night and in the evening, fear of being alone (with many subrubrics), of the dark, of death (with many subrubrics), disease, evil, that something will happen, of insanity, anxiety from ailments, from heart complaints, anxiety with palpitations, with pulsation, anxiety with difficult respiration, anxiety in the heart and in the stomach region, anxiety about health, about the future, anxiety of conscience, anxiety for others, tremulous anxiety, hypochondriachal anxiety, oppressive anxiety (4th and 3rd degree rubrics). Small rubrics comprise: fear with palpitation, anxiety and fear while alone, fear that he will die when alone, anxiety with congestion, during and from cough, fear of cough, anxiety in dyspnoea, causeless anxiety, anxiety with tension, from thoughts, about friends, fear of being forsaken, of suffering, of being murdered, poisoned, of medical examinations.
One can thus see the same picture emerge that we have already seen in the other remedies, especially the mineral ones. There is fear and anxiety related to the chest, heart, and especially to respiration and coughing. There is fear concerning health (own and, more prominently than in Arsenicum, also the health of others) and disease. Fear of being alone is also prominent, and in Phosphorus, given the overall importance of relationships in the remedy picture, the fear of being alone becomes the fear of being friendless, being actively forsaken by one’s friends. Like Arsenicum, Phosphorus is highly suspicious, with fear of being poisoned and murdered. With Phosphorus, this fear extends to being murdered in the context of a medical examination. And the same as in Arsenicum, one can again see that combined fear of dying alone at night or in the evening.
All seven remedies that have been discussed by homeopaths during the current pandemic share fear and anxiety rubrics that relate to the heart, the chest and especially to the respiratory system. In these fears, the physical symptoms find their expression on the mental level. It is also noticeable that five of these remedies – Aconite, Arsenicum, Gelsemium, Phosphorus and Pulsatilla – are among the remedies frequently prescribed for states of fear and anxiety, reflecting the many fears that have been associated with the pandemic. A further commonality can be seen among the three mineral remedies, Ant-t, Arsenicum, and Phosphorus: All three remedies are located in column 15 of the periodic table, reflecting the fear of loss and decline – be it the loss of physical health in the context of acute respiratory illness, the loss of closeness to friends and family, or the loss of our former way of life.
On the background of these commonalities, each remedy reflects the fears associated with the pandemic in its unique way. The Gelsemium state is characterised by an unspecific, generalised state of anticipatory anxiety and fear of the unknown. In Aconite, we see sudden intense overpowering fear associated with acute states, and we also see the fear of the person becoming infected who is afraid of venturing out into public places, into the proximity or even to the touch of other persons. The person in a Pulsatilla state shares this fear of disease and concerns about health, but the fear is of a more tremulous, weeping and morose kind, and it is accompanied by fear of being alone and feeling forsaken. Fear of disease, concerns about health, fear of being alone are likewise present in the Arsenicum and in the Phosphorus states. Moreover, persons in the Arsenicum and in the Phosphorus state are also suspicious and afraid of being poisoned or murdered. Arsenicum stands out due to its fear of contagion, thus reflecting a core element of the current pandemic situation. The Phosphorus state is characterised by a concern with the health of others and a fer of being forsaken by one’s freinds, mirroring another aspect of the pandemic and the situation in which we have all been living for the past year. The Arsenicum and the Phosphorus state share the fear of dying alone at night, a fear that, unfortunately, has become a reality for those patients whose infections proved fatal and who died in hospital, alone and isolated from their friends and family.
Bryonia and Ant-tart differ from the other five remedies in that here the physical respiratory symptoms are dominant. In addition to the fear symptoms related to the chest and the respiratory system, Bryonia is characterised by a state of anxious vexation and wanting to escape, mirroring a stage 2 or 3 respiratory infection. Ant-t presents the most severe respiratory symptoms, almost to the point of acute respiratory distress, and this is accompanied by fears concerning a fatal outcome of the disease.
 Jethani, B. et al. (2021). Clinical characteristics and remedy profiles of patients with COVID-19: A retrospective cohort study. Homeopathy, 110(2), 86-93. doi: 10.1055/s-0040-1718584.
 Rutten, L. et al. (2021). Data collection during the COVID-19 pandemic: Learning from experience, resulting in a Bayesian repertory. Homeopathy, 110(2), 94-101. Doi: 10.1055/s-0040-1718583.
 Valeri, A. (2020). Symptomatic COVID-19 positive and likely patients treated by homeopathic physicians – an Italian descriptive study. Retrieved from: https://www.researchgate.net/publication/340631586_Symptomatic_COVID-19_positive_and_likely_patients_treated_by_homeopathic_physicians_-_an_Italian_descriptive_study.
 Sankaran, R. (2005). An insight into plants (vol. II). 2nd rev. ed. Mumbai: Homeopathic Medical Publishers.
 Clarke, J. H. (2006). A dictionary of practical materia medica (vol. I). Reprint ed. New Delhi: B. Jain Publishers.
 Sankaran, R. (2004). The soul of remedies. Mumbai: Homeopathic Medical Publishers.
 Vermeulen, F. (2004). Prisma. The Arcana of Materia Medica illuminated (3rd ed.). Haarlem: Emryss.
 Scholten, J. (2007). Homeopathy and the elements (5th. Ed.). Utrecht: Stichting Alonnissos.
About the Author:
Margrit Schreier, Dr. phil., Dipl. psych., M.A., D.S. Hom. is a psychologist, researcher, homeopath, and mindfulness meditation teacher. After obtaining her doctorate and her Habilitation in psychology from Heidelberg and Cologne University, she worked as Professor of Empirical Research Methods at Jacobs University Bremen for 17 years (where she continues to hold an Adjunct Professorship in Empirical Research Methods). As a homeopath, she graduated from the School of Homeopathy in Devon in 2013 and went on to obtain her qualification as a ‘Heilpraktiker’ (naturopath) in Bremen in 2015. Since 2016, she has been in homeopathic practice, with a focus on highly sensitive persons (sensory processing sensitivity). She is also a graduate of the Mindfulness Meditation Teacher Program run by Tara Brach and Jack Kornfield and is teaching mindfulness courses.
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