Meditative approach in chronic skin complaints

Chronic skin complaints like psoriasis, eczema, and lichen planus virtually constitute the bane of a person’s life. The anxiety and the social embarrassment due to the complaints is often more agonizing than the suffering itself. This becomes a perpetual concern for the patient and the family. Often, we get cases where every mode of treatment is tried before they finally approach us. The chronicity and the direct body-mind connection in such complaints necessitate the need for a systematic holistic understanding.

Despite a good totality, there are many relapses in such complaints. The patient loses hope and sinks into a state of despair. The duty of the homoeopath in such cases is to be a silent facilitator and to bring forth from the patient’s subconscious the state of agony and despair that he has been routinely living. The homoeopath plays the role of a passive observer to encourage the patient to observe and report the contours of his own experience. When the experience emerges to the foreground, it provides a proper grip on the patient’s inner song. The very crystallization of the patient’s experience itself initiates the healing process. The physician here has to go with the flow of the case and help the patient disconnect from his complaints. This is often possible by the use of meditative approaches.

Below are two cases of chronic skin conditions seen. The cases have been edited for brevity. Abbreviations used are P: patient, JS: Jayesh Shah, HG: Hand Gesture.

Lichen planus is an inflammatory autoimmune condition that can affect skin and mucous membranes. It usually appears as purplish, flat, itchy eruptions on the skin, in the mouth, vagina, and other areas covered by mucus membranes. It forms lacy white patches with painful sores. The typical signs and symptoms include purplish flat-topped bumps, most often on the inner forearm, wrist or ankle, and sometimes on the genitals. Itching invariably accompanies the skin lesions. The blisters may break to form scabs or crusts. On mucous membranes, it may present as white spots or patches in the mouth — inside the cheeks or on the gums, lips or tongue, or painful oral or vaginal ulcers. Hair loss and scalp discoloration are also common with lichen planus. This may also affect the nails, causing nail damage or loss of nails.

Case 1
Tthis is a case of 63-year-old female who had been diagnosed with oral lichen planus. She was first seen on 4th July, 2012. She is a public relationship officer at Tata hospital, a famous cancer specialty hospital in Mumbai. She had been to various doctors for the same problem with hardly any relief. She entered the office and said that she was feeling anxious about what questions might be asked to her. She could not describe this anxiety further. 

A human being has two minds. One is the thinking mind and the other is the experiencing mind. These days, I work a lot in giving the experiencing mind a chance to experience whatever the life force or the vital force has to experience. This is done by simply asking the patient to focus on the experience. So, I asked her to give attention to this anxiety.

The patient said that the anxiety was of the unknown as to what questions would be asked.

While the patient is in an experiencing mode, the best way to facilitate this is by suggesting to him/her to close eyes and take some deep breaths and follow the directions. Asking them to take deep breath helps to connect with the experience. In a way, it is like a guided meditation.

As she focused further on the anxiety about the unknown, she felt alone, like there was no one. Not even feeling her body parts. Just a few minutes into this meditative state, she started experiencing relaxation.

Now, we see that the life force initially feels anxious and the anxiety is concerning what questions are going to be asked. As she gives attention to this anxiety, it abates, and relaxation sets in. This is the beauty of the meditative approach, the patient starts to feel at ease during the consultation itself. Our job is to just facilitate the vital force.

JS: Give this relaxation all your attention.

P: It feels light. Like my body is travelling somewhere. Someone is asking me something and nothing is felt in the body. It feels like I am flying somewhere.

JS: Give this flying full attention and experience it.

P: My brain and my mind feel very free, like I am getting sleep. Everything has become silent. My brain and body have vanished. It is just like a vacuum. Nothing is there. I am floating somewhere but I don’t know where I am going. Just like an empty space. I am getting lost in this space.

JS: Give this experience all your attention.

P: Now, I feel I have stopped. I am going backwards. It feels like I am going backwards and backwards, down and down. I don’t know where I will go, again I have started going up. I am floating upwards. I am swaying like a pendulum.

JS: Just experience this swaying like a pendulum.

P: I am in the sky, there is no ground below. I am just going ahead and sometimes behind.

JS: Environment of sky, no ground below your feet, going up and down… Give this your entire attention.

P: I am going high up; I am seeing a bright light. There is bright light in front of my eyes. As I am going higher and higher, I see a white light and there is no darkness. The light is spreading everywhere and I am travelling. My speed is reducing, I have become slower and slower. I feel I am going in the right direction and I feel hot, there is power in my body. It is like a wave of energy running in my body. It is like a circle, there are rides in which you sit and go round and round. There is numbness in the body. It is a nice experience. I am enjoying this journey.

This is the point where the patient sees a light and this light has a lot of potential to heal. If the patient is able to experience this light, then a sense of ease starts to set in. At this point, I ask them to take few deep breaths, ask them to feel the chair they are sitting on, feel the floor, feel the place they are meditating in and ask them to open their eyes when they are ready. 

The meditation ended there. From there, we began our classical case-taking process. The patient said that she dreamt of going somewhere, walking somewhere but not getting there, and she just kept walking and walking. To her, it felt as if she was going by bus and the bus was not moving, so she did not reach her destination. She was constantly trying to see and find her destination.

The patient recalled one more dream: she was going by bus with her brothers and sisters. Midway, the bus stopped and they all got out and waited for another bus. However, the bus did not come and they were not even aware of where they were going. The only thing she remembered about the dream was that she was travelling.

This was very interesting. At the beginning, she said that she has this lichen planus and that she has been to so many doctors without result. Then, in the meditation, we see that she is going back and forth but not arriving anywhere. The experience in the meditation is of enjoyment. When we asked about the dreams, the same phenomenon of ‘trying’ is seen. This is the commonality of the case. Now, our job was to find the experience of this trying and struggle, which would lead us to the sensation. This trying was nothing but her coping mechanism, which is the ringworm miasm.

In the Sensation Approach, depending on the pace, the rapidity and the level of desperation, the states of disease and remedies are identified and classified  into ten miasms, ranging from Psoric, which is the least desperate, to Syphilitic, which is the most desperate. The other miasms include Acute, Sycotic, Typhoid, Malaria, Ringworm, Cancer, Tubercular, and Leprosy, each having a distinct character. The situation of the ringworm miasm seems to be one at the limit of the person’s capacity. There is hope of possible success and so a lot of effort is made, but each failure makes her give up and accept her limitations.1

I then tried to ask her the experience of this but she is unable to go into the experience. So, we asked her to describe the chief complaint.

The patient said that she was on an outing in Jaipur with her family. During breakfast, the snacks felt too spicy, as if full of chillies. Her mouth started to burn and this continued into the next day. She noticed multiple cracks in the mucosa of her mouth. The inside of her cheek had become rough. Her brother-in-law, a physician, prescribed some medicines along with milk and probiotic yoghurt, but here was no relief at all. Then, she was given vitamin B complex shots; she got admitted to hospital and underwent all possible investigations. Finally, one physician at Tata hospital diagnosed her condition as oral lichen planus. In his opinion, there was no treatment in modern medicine except steroids, which she refused to take. Then, she tried homoeopathy for six months with no relief either, followed by all possible home remedies without success.

Her main complaint with this lichen was difficulty in eating. Any food felt too spicy to her. Her mouth was always dry and burning. She could not eat hot food at all. Cold ameliorated, so she retained some cold water in her mouth for 2-3 minutes after having any food, which provided some relief. Due to this condition, she was deprived of eating food like samosa, kachori and chaat (spicy and fried Indian snacks). She loved to eat and drink, but could have only curd, while everyone had tasty food. She was interested in travelling and seeing new places, as she was of the opinion that God has made so many things in the world and seeing them gave a good feeling. Apart from travelling, she loved to be in water, getting wet in the rain. She preferred travelling over buying jewelry and sarees. She likes to remain active and is a member of many clubs; she loves watching dramas, going to work at the hospital, going to the Lions club. She does not come home until 11pm. She does not like to sit idle or in front of television, which she calls an ‘idiot box’; to her it is a waste of time to sit watching the TV; it made her restless, like a helpless situation, as if she is tied up. The main experience for her to sit in front of the television is of boredom.

Let us understand this case in parts. First, we understand what comes up in the meditation. The most prominent thing that came is going up and down, back and forth and not being able to reach her destination. The experience of this is enjoyment. So, we see that she is going somewhere, not reaching that place, and this is an enjoyable experience. Then, we move on to her dreams: in one dream she narrates that she is going with her brothers and sisters in a bus and they don’t know where they are going. The bus stops in the middle and they are waiting for the next bus to come. Here again, we see that they are travelling to a certain place but the bus stops, and they are not able to reach the destination. So, the important thing that runs in these two subconscious areas is trying, not being able to reach the destination though trying to.

The same phenomenon of ‘trying’ is evident: she is going from one doctor to another to another but there is no relief. Then, she gives up, tries homoeopathy, then home remedies, and then, gives up. So, this trying and giving up is a pattern we see running through the case. This is how she is coping; this is the miasm of the case: ringworm. Next, our aim is to understand the sensation, that commonality or theme, which runs through the case.

We see that she loves enjoyment and travelling and she is fond of eating. She is a very active person; she likes to see the dramas, travelling, seeing the world, going to new places, and getting wet in the rain, all of which make her happy. The other side is to be idle, which she hates, especially sitting in front of television and wasting time, which would be the last thing to do. This makes her feel bored. These are the two polarities in the case. On one side is the enjoyment, the other side is the boredom.

Last but not the least, we see that her disease is depriving her of food or spicy things like chaat, kachori, etc. She is forced to have bland food. So, the main sensation in the case is:

• Enjoyment by travelling, getting wet in the rain
• Entertainment by watching drama
• Seeing new places, travelling

The other polarity of the above is:

• Boredom; sitting in one place in front of the “idiot box” (the television)
• Pain
• Blandness

Once we arrive at the sensation, our next job is to finalize the kingdom. Here, we see that the issues are: sensitivity and reactivity. The problem is not experienced as if there is something lacking or as a victim-aggressor phenomenon. The problem is more of sensitivity and reactivity. So, this sensation falls under the plant kingdom. A systematic and prolonged study of cases led to a definitive understanding: when classified at the level of experience, the patient’s experience could be classified into three kingdoms: Plant, Mineral, and, Animal. The main experience or the Vital Sensation of the Plants has to do with sensitivity, of being affected and reacting. The main sensation of the Mineral kingdom has to do with structure, whether I am lacking, if I have to complete myself, or if I am losing my structure. The main experience of the Animal kingdom is survival.2

Further study of plant families led to understanding that the core experience of the vital sensation in them is expressed as two opposite polarities. In this case, the next step is to understand which plant family has pain, boredom, and blandness, as well as enjoyment and entertainment as its central issue or core experience. This is seen in the Piperaceae family. Unfortunately, there is no remedy in Piperaceae family which belongs to the ringworm miasm. So, we studied all the remedies in Piperaceae family; the closest was the remedy Piper nigrum, which is classified as a sycotic remedy.3  

After a year of treatment, the lesions healed completely. In her follow up on 31st July, 2013, she said that there is no more pain or burning, meaning no more deprivation of food. She is now able to eat spicy food with no aggravation. She was given Piper nigrum 200C for four months, which was then stepped up to 1M. She was given approximately one dose every month, until her complaint settled completely. She is very happy as she can now enjoy all food. Everyone asks her how the ulcers disappeared when modern medicine doctors had given up on her case. She enjoys good health and feels very happy and grateful to homoeopathy. She refers many patients to the clinic, being more than highly satisfied by her own recovery.

Case 2
The next case is of a 44-year-old man, suffering from palmer psoriasis since many years, first seen on 25th January, 2012. He had been prescribed many remedies by his wife, who is a homoeopath. The remedy that had maximum effect was Staphysagria. He had many small eruptions on the palms, with cracks and occasional itching. When he entered our consulting room, we observed that he was of average build. When he sat down, he was asked how he was feeling in the moment, to which he replied that he was thinking that his consultation should go well.

Here, I again try to coax the experiencing mind to the fore, allowing it to experience whatever the life force has to experience.

As this is explained to him, he spontaneously resonates with the experience of being calm.

The moment he says ‘calm’ I am happy, this means he is plugged into an experiencing mode instead of the thought mode. So, I ask him to close his eyes and experience this calm; to sink into this calm and trust his experience.

As the attention is focused on calm, he started experiencing stillness, peace, and a relaxed state of mind. He started to feel lighter. As the meditation continued further, he started getting some thoughts, where he was again directed to take deep breaths so as to facilitate the experiencing mind.

He started experiencing some sort of heaviness in the head and a sensation of heat in the face. The expression of heat was bright like sunlight. As the meditative process intensified, he started to feel restless. The state of inactivity started disturbing him. At this point, he resonated with the experience of the distress of this disease. It made him feel restricted. He said that the psoriasis robbed him of his freedom. He could not do what he wanted to do, like there was a restriction in touching things like soap, moisturizer, etc. This restriction produced irritation and helplessness. While he was saying this, his hands became tight and folded.

His consciousness had plugged into what his vital force was resonating with. Since his life force had identified this distressful experience, our role here is of a facilitator, a guide, providing him assistance to go further into this journey of life force.

As he came in contact with moisturizers, the skin started to react, initially in the form of itch, which was an uncontrollable urge, then there were blisters, followed by peeling and sloughing off of the skin. This was not a nice feeling for him as it made him feel dirty. The use of his hands became restricted.

JS: So, what is the experience to have this dirty skin, which itches, cracks and peels off?

P: This produces lots of anger.

JS: What is in the center of that anger? Anger is what you become. What is the feeling that makes you angry?

P: The pain is my helplessness. All those restrictions, all your movements are restricted, at home, at the office, and everywhere. It hampers my movements. My freedom is curtailed.

Here, he spontaneously goes to another aspect of his life and said that his desire was to ride a bike or drive a car. The feeling was again of restriction as he cannot drive. He liked to move and be active; this state of inactivity either produced boredom or sleepiness.

Since he has spontaneously shifted to his love for driving, it is appropriate to ask him about his hobbies. When asked, he expressed his passion about travelling. He also likes reading, solving challenging problems, and music. His most intense passion, however, is travelling. It was interesting how he perceived the love for travelling. For him travelling was about seeing new places, new cultures, how people are being brought up, especially how children are being brought up. He further elaborated, saying that we had to ensure that children don’t cross limits: it should be clear when they should be allowed to do a certain thing and when they should not be allowed to get carried away. He was the same way with his children.

This is the general sensation in the case. His skin allows him to do and not do certain things, and he, as a parent, allows and restricts his children from doing certain things. This is his other song.

He becomes very angry and violent when his children cross their limits. He would scream and shout at them. However, this reaction would then make him feel helpless. He feels that he should have handled the situation in a better way, and then, he starts scratching his back again.

We then move on to his dreams. He dreams of missing trains and passing stools. In childhood, he had dreams of snakes. However, this dream did not carry enough energy, so we moved on to his nature. He likes doing things, always likes to be active. When he is free and doing nothing, he becomes restless. He says this with closed eyes. He has two major fears; one was the fear of cardiac arrest and the other was for his children’s education. He is constantly worried about these two things. The case ended here.

In the past, he had joint pains with great difficulty in walking. He has also suffered from jaundice and measles. During the whole case, it was observed that his legs were constantly restless.

On analyzing the case, we have to see what is the common to the case, what is it that runs through different aspects of his life, whether it is the skin complaint, the joint pains, his hobbies or his nature per se. A homoeopath must skillfully trace out the commonality running through various aspects of an individual’s life. So, when we look at his case, his skin problems, his nature, his hobbies and his past history, we see that the case revolves around the polarities of freedom and movement on the one hand, and limitations and restrictions on the other. We see that he is sensitive to being restricted and wants to be free and on the move. The state of inactivity affects him, irritates, and frustrates him. This enables us to understand his experience as plant sensitivity. There is a sensation and there is a reaction.

This kind of sensitivity to restriction, limitation, and the opposite of which is freedom, movement are classical of Anacardiaceae family. Once the kingdom and subkingdom are clear, our next job is to understand the miasm. This disease or eruptions come from time to time, they are not constant. They come up acutely and this makes him feel helpless; his work is hampered or hindered. This is malarial miasm. We see the same in his anger: he gets acutely angry, and then repents. This pattern of acuteness and acceptance is the malarial miasm.5

The remedy from the Anacardiaceae family that corresponds to the malarial miasm is Rhus radicans. 

Also, when we read our literature, we find the following references which match the symptoms of the patient.

Murphy’s materia medica6

SKIN - Itching, pricking, stinging. Dermatitis. Poison ivy and poison oak rashes. Hard, red eruptions. Inflamed tubercles, elevations, hard pimples. Pustules, blisters, watery pimples. Vesicular eruption, some disappear without rupture of the cuticle, others burst. Yellow, acrid fluid from eruptions. Erysipelas, especially in hot weather. Small boils. Ulcers. Swelling of the lymphatic glands.2

Here, we see the two sides coming together, the system on one side and the symptoms on the other. This is the perfect coming together of the new and the old school of thoughts, the Synergy. This gives us confirmation about the choice of the remedy.

After a year and half’s treatment, on 20th July, 2013, the patient said that the change has been remarkable. He says he is feeling good, calmer, and patient. Physically, he feels energetic. The skin is much better. Occasionally, he has episodes of throat pain. The acute episodes subsided with the administration of the constitutional remedy, Rhus radicans. Blisters, even if they come, heal on their own. They are not bothersome now, they vanish within a day. He received Rhus radicans 200C to begin with, which was given once every month for six months. He has no more skin issues and he is off treatment. He is enjoying  a good healthy life.

In patients with deep seated pathologies and chronic suffering, it is important to create space and allow the experiencing mind to play its vital role. The journey from the thinking to the experiencing mind may be spontaneous or more often facilitated. The patient has to be given encouragement to be in the moment and to trust whatever comes up, to have faith in his experience. The patient’s life force will lead the experiencing mind to where the energy of the case lies. Once the patient has connected to a resonating phenomenon, then my role is to facilitate this process and take it as deep as the life force wishes to experience it. One of the ways to facilitate this process is by giving gentle suggestions to the patient to just give attention to this phenomenon. What comes when taken without any prejudice, combined with the understanding of the Sensation Approach, is a journey of awareness and healing.

Cases written and edited by Sneha Vyas and Devang Shah

References
1,4 Rajan Sankaran, The Sensation in Homoeopathy, Miasms, Second Edition, 2005, Homoeopathic Medical Publishers

2 Rajan Sankaran, The Sensation in Homoeopathy, Vital Sensation and Kingdoms, Second Edition, 2005, Homoeopathic Medical Publishers.

3 Rajan Sankaran, Piperaceae, An Insight into Plants – Vol 3, First Edition, 2007, Homoeopathic Medical Publishers, Mumbai

4 Rajan Sankaran, An Insight into Plants, Volume 1, Second Revised Edition, 2005, Homoeopathic Medical Publishers.

6 ReferenceWorks Pro, 4.2.1.1, Michael Hourigan and David Kent Warkentin, Kent Homoeopathic Associates.

Photos: Shutterstock
Blurred white light; Kues
Close-up of a yound man meditating; lightwavemedia
Magic lotus flower; Vadim Georgiev