Working with families

One of the shifts that is implicit in my shift as a clinician moving from individual holistic health to the psychological wellbeing of individuals, is that in the latter it is necessary to consider the person’s environment as an organizing principle. In my work as a homeopath I took into consideration the effects of the environment and the person’s own view of reality and their understanding of their environment and I looked for the underlying organizing principle why they found themselves in that environment. This is a fascinating study and one that can point to many inner organizing themes in the person’s psyche.
Yet in psychotherapy, while working with the individual, it is necessary to pay attention to the family structure – or the lack of that – when striving to bring about health and balance in one’s inner world. In homeopathy I did not consider it to be my role to help my clients understand their family structure and their place in it, nor using that matrix of family bonds in relieving them from their underlying anxieties and discomforts, I merely needed that understanding to bring us to a general understanding of the person’s constitutional makeup.
In therapy the inner experience of the person is dependent on the maintaining factors, the environment. (It is called “maintaining”, when the circumstances cause suffering and as long as the person is in that environment, healing is extremely difficult). Bringing light on an experiential level to the inner workings of these relationships I believe I can be of utmost help as a therapist. It is most often true about people that they are in certain environments and relationships for a reason but in many cases the person is tied in that particular situation and has no option to move out of it. So while keeping it in mind that this person has a larger organizing principle in their life that keeps them in that particular unconscious set up, a way to dissolving that discomfort can be through solving the puzzle in their family environment.
A large group of people for whom this is true are children. This is complicated enough for young children who are stuck in abusive or unhealthy circumstances but I find even more excruciating some of the situations of inner and outer conflict and paradox of adolescent life. Adolescents are on the edge – they are still children but they are budding adults. Several clinicians and authors spent their careers working with adolescents and tried to untie the knots of the complex hardships of transition from childhood to adulthood, in this most active phase of individuation. I find it a rewarding thought as a clinician that I might be able to intervene at this juncture of one’s life.
Adolescents have the mental capacity to see the intricacies of mental emotional and relational (interpersonal) life yet they are operating on the platform of the well-tried and familiar childhood. It is often the very parents who admire their children and want the best for them in becoming healthy adults, who keep them back from making those steps and allowing them to detach from them. It is hard to see a loved one leave. Working with families of adolescents is rewarding as I feel I am allowed into the life of people at this intricate time when one (the parent) needs a little whisper of help to let go and the other (adolescent) needs the whisper of encouragement that it is ok to go.

Importance of mother's state during pregnancy

I have been often wondering why the mother’s state of mind during pregnancy is important when prescribing a homeopathic remedy to a child. I have thought and noticed that if the mother had specific traumatic events during pregnancy it must have affected the child and not only in a straightforward manner but also in a more chronic way. This, I have explained, was due to the fact that the mother had a certain predisposition, which corresponded to the trauma or her state of mind during pregnancy and she ought to display it throughout her mothering, not only during pregnancy, thus affecting the child in his or her very essence. This usually brought under my scrutiny clues to whether or not the child reacted to the mother’s state in any observable manner. I often found it did, so I explored the mother’s disposition during pregnancy, tried to see if it had any elements that were unusual for the mother outside of her pregnancy, and included that in the remedy picture for the child.
While this is still relevant and stands true in my homeopathic thinking, I have noted a connection between the underlying logic of including the mother’s state during pregnancy and the child’s constitutional make up. This came through psychoanalytic explorations of the infant’s psychic development.
According to some psychoanalytic theories, the infant is born into the world without a self-concept. The infant does not know about her limitations, physical boundaries and does not have the concept of predicting or expecting future events, like feeding times, hunger, thirst, pain, digestion, urination. All these events and sensations happen to the infant and together with the environment’s response to these events and sensations, the infant slowly but surely starts to develop its own being and understanding of the world.
The mother (or primary care taker) is a crucial being in the infant’s developing self-concept. This is the person, who responds to the infant’s needs, urges, cries, smiles, and tries to read the infant’s bodily signals, most often in an attending fashion. This care taking, thus plays an essential role in the infant’s development, not only in psychosocial and physical development, but also in the very creation of the infant’s self –image. Taking it one step beyond this actual physical care taking during the initial stages of the infant’s life, the mother, as a container and care taker was there for the infant during the pregnancy as well. The mother was the containing environment the infant (the fetus) was surrounded by, received vital signals of life and well being from, and essentially everything that got absorbed into the infant’s being.
This conceptualization of the origins of the developing self, gave me the missing piece I needed to understand the fundamental reason for inquiring about the mother’s state during the pregnancy. With this frame of reference, I can navigate my way easier in the maze of critical and non-critical information a mother can provide the homeopath during the interview for her child. The mother, as the environment, or container plays a crucial role in the creation of the very matrix of the developing self of the fetus and infant, thus providing clues to the personality and remedy picture of the child through her own inner experience and world of vital sensations.

Empathy

As I was working on rebuilding my website (which now includes a track for homeopathy and a separate one for psychotherapy - check it out:), I came across a comment on my book where I describe homeopathic case taking as bypassing the emotional level exploration. The author of the critique seemed not to share my sentiment about this issue. I have found rejection of this idea in some professionals in the past and i am wondering what is the source of this rejection. Why do other clinicians reject the fact that it is possible - and possibly preferable - to avoid the whirlwind of emotional layers that can bring us to faulty conclusions and misconceptions of our clients.
I believe that true empathy lies in an ability to see beyond our client's emotions. If we strive to understand what is underneath the emotion, we will arrive at very personal and individual layers of the person's view of reality and inner world. I believe that using the emotional layer as a diving board to more person-specific areas of one's inner life is a useful tool in therapy and homeopathy.These are the layers of the unconscious which have roots beyond emotions. We might have emotional reactions or manifestations of these deeper roots but the roots themselves are not (necessarily) emotion-based.
The text from Sensations goes like this:
"Before we examine the cases of the animal kingdom, I want to revisit a key component of the Sensation Method of homeopathy so we can see how it applies to the following examples. The power of homeopathic case-taking lies in the fact that it does not involve the emotional layer. As I have mentioned before, our goal as homeopaths is not to explore the emotional layer, nor even the layer that feeds the emotions. Our goal is to arrive at the sensation level and hear the words that describe that level. As we are humans, and homeopathy utilizes our ability to verbalize our feelings, sensations and experiences, we use words to transfer these ideas. But beyond the actual words the coherency of speech has only secondary importance. Describing sensations is often far from what the person is used to. It is far from the realm the ego feels attached to or protective of. Our ego is what works the “pain body,” as Eckhart Tolle calls it. With the Sensation Method we go beyond this body and thus trick the ego.
Once the ego has no access to what we are talking about, we can truly describe our core problem with no pain and suffering. There is no guard invested in keeping the pain body as intact as possible. This pain body is the very obstacle to health. Our ego does not want us to be free of it. It wants us to stay ill-healthed because that is its only chance for survival. This process has a dual benefit. First, we can reach the core problem without touching painful, tender spots in the whole being  we don’t have to stir up traumatic experiences. Second, upon reaching the core level, we touch something truly essential, and once that essential core is addressed and healed, healing will emanate into the whole being, transforming the whole into a healthy state".

More on the intersubjective nature of the therapeutic encounter
Homeopaths conceptualize their cases in their own mind and they do not share this with their clients. There is no forum for it, as the system of thinking in the sensation method is far removed from the human interaction, which can be "explained" or commented on during a session. The most useful comments I am aware of in homeopathic consulting work are the connections we can make between mental, emotional, and physical symptoms. These are often eye-opened for our clients.
I find the lack of communication on the level of conceptualization a setback in homeopathic work. I believe that the homeopath and client relationship could be enhanced if this type of communication was activated. Many psychotherapists rely on and use the here-and-now events of the session and use the transference and their relationship with the client a sort of practice space for both understanding the client's issues and their healing process as well. If a similar way of interaction were to be utilized by homeopaths, the remedies' effects could be prepared and enhanced, thus treatment could be easier incorporated into the client's experience. It is not simple to point out what this process would be as the majority of these processes - both in psychotherapeutic healing and in homeopathic healing, are unconscious.

Modern psychoanalytic thinkers, like Mitchell in "Hope and Dread in Psychoanalysis" published in 1993, talk about the interpersonal aspects of psychoanalytic psychotherapy. While there are many differing concepts in modern psychoanalysis, they all seem to agree on the crucial role the therapist's subjectivity plays in the treatment of their patients. Mitchell talks about the way the analyst conceptualizes, organizes the patient's experience. He considers modern analytic thinking to be different from the traditional, Freudian view in that today we focus on the patient's inner experience as opposed to the Freudian view, where the analyst created a conceptual frame which through his interpretations he conveyed to the patient, who in turn internalized it, used it for their own self-healing. Today psychoanalytic therapists seek to bring forth the patient's own experience, through which - according to Mitchell - the person's meaningful self-experience will develop and manifest.
I found this quite interesting, as the way I work is a process where the emphasis is on the inner experience of the person. Mitchell continues with his thought process and not only maintains that the person's inner experience is the cornerstone of modern psychotherapy but he also explains that the therapist's own conceptualization has a powerful impact on the emerging conceptualization which will be co-created by patient and therapist. This is a process, which I found fascinating. I started wondering what affect my understanding of the homeopathic remedy picture has on the process of the healing of my clients. How does it affect the whole of the process that my thinking is in the framework of homeopathy and that my conceptualization of the client is on the level of their vital sensation? If I am experiencing my client on the level of the vital sensation and my comments and guiding inquiry stays on that level, it greatly affects the type of healing and self-conceptualization of my client. This is definitely a direction to pay attention to and explore.

My shift to psychotherapy continues

The following is from my Master's thesis for my clinical psychology program, entitled Hand Gestures and Somatic Manifestations: The Bridge to the Unconscious. You can see how I am entering ideas from my understanding of the Sensation method of homeopathy, combining them with the vast knowledge that has been gained in psychoanalysis and psychotherapy. This is an introduction to this work, more to come later.

“A man’s states of mind are manifested, almost without exception, in the tensions and relaxations of his facial muscles, in the adaptations of his eyes, in the amount of blood in the vessels of his skin, in the modifications in his vocal apparatus and in the movements of his limbs and in particular of his hands”. (Freud cited in Sletvold, 2010)

In psychodynamic therapy the unconscious realm of the human psyche is the primary target of our investigations. Since the birth of psychoanalysis many approaches have been established to reach the unconscious, and make it available for conscious understanding and transformation. The tools psychotherapists use to achieve this goal vary greatly according to the therapist’s conceptual framework. In recent decades the importance of the body-mind connection has been increasingly emphasized, and with it a focus on understanding bodily expressions of psychic phenomenon. While various approaches have been established under the umbrella term “somatic psychology”, the “embodied analyst” is an emerging topic in the field of psychoanalysis as well. Just as the interpersonal aspects of psychoanalysis have come to the forefront in the last several decades, so too have experiential and person-centered approaches been geared towards addressing issues that arise in the here and now of interpersonal experience. In particular, experiential and person centered approaches provide a way to understand and access individuals’ inner experience through their bodily felt sensations.
My previous specialty, the Sensation Method of homeopathy heals by readjusting the core of the ailment, the deep seated imbalance, through identifying core bodily sensations in the person. Having experience in working with individuals in this modality, I know that the body expresses itself in rich ways that go beyond the narrow expression of the spoken word (Ran & Menyhert, 2007). Beside the main body of information that comes through a verbal narrative, homeopaths pay attention to clients’ bodily symptoms, their body language, the tone of their voice, their hand gestures, and even bodily reactions to their own instinctual art work, or doodling, and free associations.
This paper is an initial exploration of several authors’ and clinicians’ contributions to the field of psychotherapy where the goal is to find the layer of the unconscious that has meaningful clues to one’s emotional, mental, and physical pain. Through exploring body language, more specifically hand gestures, we can find ways to approach, locate, and understand unconscious material which is not readily available for verbal expression. Through studying the significance of hand gestures we can learn about the deeper layers of the psyche and we can explore connections that without this tool would be unavailable. The hypothesis that clients’ hand gestures are meaningful tools that help us reach the unconscious is not a new idea but the specific use of hand gestures in the context that is explored in this paper is a combined and enhanced understanding from previous authors.