Inadequate and neurotic: a case of Baryta bromatum

This is a case of a male patient, age fifty, suffering from neurosis bordering on psychosis. He is a lean, emaciated person, with premature graying of the hair. He is a policeman by profession. He comes with his wife for homoeopathic consultation.

D: Please tell me what is your problem?

P: I get a lot of sweating at night, especially after covering. This part of my lower back hurts. Then I have got some red spots here (shows spots in region below right clavicle and near shoulder). I have a history of typhoid in childhood where the fever was up to 106 degrees F (41C). And if anything happens at the workplace, I don’t feel enough courage to go there (HG: moves both hands forward).

D: Tell me a bit more, tell me slowly. You are doing well, tell me a bit more. What is affecting you the most?

P: I feel fearful, if something happens on duty. I am in the police. If anything happens, if any accident happens, if I have to catch somebody, then I don’t feel the courage to beat him or I don’t feel the courage to go there.

D: Hmm, hmm. Tell me a bit about it.

P: If I’m alone, then I can’t, but if I have somebody with me, then I get that much courage. If I am alone, then I don’t feel courageous.

D: You don’t feel courageous. Tell me more about it, that fear you feel if you have to catch somebody or if you have to do something in your duty?

P: I don’t feel that much daring to catch him alone and beat him (HG: closing fist of right hand).

We see here that there is a situation where accidents and other frightening situations happen, but our senses should be alert in order to understand what is peculiar for this individual in those situations, as the same situation will excite in each person an individual expression. In this case, this man who is a policeman feels lack of courage. This is very peculiar - it seems illogical because his profession involves protecting the society. Imagine that the person who needs to protect others feels, himself, a lack of strength and daring.

D: What do you feel?

P: I get afraid. How to catch him? How to beat him? ([HG: fingers of both hands flexed at interphalyngeal joints, as if catching something).

D: What fear do you feel?

P: I feel, how will I beat him all by myself? It means, when these accidents happen, I feel afraid of going there alone (repeats previous hand gesture).

He is in a situation of having to handle the dead bodies or injured persons following accidents that happen at the railway station. He has to manage these cases in terms of first aid, reporting to the appropriate authorities, and making decisions about sending injured persons to the proper hospital.  And in this situation, he feels a tremendous lack of courage. Let’s understand this fear in more depth.

D: Tell me a bit more about that fear you feel.

P: It means, if a companion is not there, then I don’t feel courageous enough to go there and do something (HG: closing fists of both hands). How should I go alone? That is my fear (HG: brings together all fingers).

D: What will happen if you go alone?

P: If I go, then I don’t understand what to do, how to do it. I don’t feel courageous to go there (HG: brings both hands forward, brings fingers of each hand together and then closes fist).

D:  What is this (that you are showing with your hands)?

P:  Strength... I don’t get that strength (HG: closing fists of both hands).

D: Just put all your attention on that gesture. Do it one more time.

P:  (Repeats the gesture)

D: Yes, tell me more about this.

P:  It means, I should go and catch him but I don’t feel that courage (HG: first brings both hands together as if catching something and then closes fists of both the hands).

D: Tell me a bit more about courage?

P: I should catch him. If there is thief, then I should catch him and take him to the police; that doesn’t happen.

D: If you catch a thief or if you go to the site of the accident, what might happen?

P: If some accident has taken place, then we should take that person to hospital. If somebody is there, then we get the courage to do that. It means my head or brain doesn’t work (HG: closing fists of both hands).

We see that in such situations two things happen: one is that he feels a strong need for a companion, and the other is that his brain does not seem to work.

D: Tell me what other fears you have?

P: I would feel fearful if it is dark.

D: What will happen in the dark about which you will feel afraid?

P: I feel fearful if I go in the dark. Now, what to do that this doesn’t happen? What should I do? I don’t feel courageous enough (HG: brings both hands forward with semi-flexed fingers).

He comes back to the same feeling, that he lacks courage. This is his basic state, his deepest core: in situations where he has to be in charge, he feels a tremendous lack of courage.

D: What happens when you see a railway accident?

P: How to go and what to do? Sometimes, coolies are not there. If I go alone, and the public irritates you or troubles you, then what to do? (HG: closed fists of both hands).

D: The public bothers you? What do they say?

P: The public says: “Take them immediately.” They don’t have patience.

Can you imagine what this man must be going through? There is an accident that happens on the railway track, and then this lean, emaciated man is supposed to take charge, to take the whole responsibility of the situation. There is all the chaos of the public, some people in panic, some in fear, others becoming aggressive, and he, as a policeman, has to handle these people along with the dead body or injured persons. On top of this, a colleague may not come with him, which further intensifies his distress. Now that we have a full understanding of the situation, where he feels completely inadequate and incapable, let us understand the other aspects of his nature, and see what comes up.

D: How is your nature? Will you tell something about it?

P: My nature is very... silent.

D:  Silent?

P: Haan, not talking much. I don’t dare much to talk with the person in front of me.

D: Tell more about this - what fear do you feel when talking with somebody?

P: If anyone is talking about family matters or any other thing, then I don’t dare to talk much. I am not able to speak.

D: What fear do you feel then?

P: The other person will say that you can’t talk properly… It is difficult for me to talk with strangers very easily.

So, he is very timid person. He has a kind of shyness where in the presence of strangers he is not comfortable. So, here also we see a repeating phenomenon of a lack of courage.

D: What dreams do you get when you sleep?

P: I don’t get dreams. I become very sweaty and I don’t get sleep.

D: Try to think - what dreams do you get?

P: I never get any dreams, only some time back when an accident took place - at that time, I was afraid. Nothing else. I saw that and I felt fearful… When accidents happen, then I feel fearful sometimes in dreams.

D: What do you feel on seeing those accidents?

P: Like hands or something get cut.

D: Try to recollect, what were you afraid of in childhood?

P: In school, my brain was not working when studying… I was suffering from typhoid, and because of that my brain was not working while studying; I couldn’t soak up whatever I had read.

D: For how long have you had this fear in your job?

P: Now, it must be for the last 2-3 months.

D: It wasn’t there before that?

P: Not this much.

D: What happened?

P: Some accident happened in Wadala. At the time, my companions ran away and I was alone. Now, how to go alone? The public just can come and beat us. Just that (HG: brings both hands close together with palms facing each other).

D: Then, what did you do in that situation, after your companions ran away?

P: I didn’t go alone, I was afraid - how to go?

D: At that time, what did you feel in your body?

P: I felt only this. How to go?

D: What would the public do?

P: If you don’t carry them away quickly, then the public comes to beat you. These things have happened 2-3 times before… For the past three months, these people are stalking me, saying that this fellow was there. These journalists… (HG: brings hands close to each other with palms facing each other and fingers semi-flexed).

D: Okay, tell me what happened later that day?

P: Nothing happened that day. They came after me after 2-3 days saying that this fellow was there, he was there. (repeats same hand gesture)… They are behind me all the time. Then, I feel fearful and I can’t gather the courage to do the duty alone. (repeats same hand gesture). I am always alone. I am alone on the railway station. There was our vehicle standing outside the station. The other companions ran away and I was alone there. I couldn’t gather the courage to go in there alone - how to go alone? Only this thing happened there and nothing else.

D: You couldn’t take anyone’s help there?

P: Nobody helps; the public doesn’t help. When no one was with me and I was alone, I couldn’t dare to go there.

D: Why doesn’t the public help?

P: The public says, you alone should take them, what if we have to face any action? That is what the public says. So they don’t help you. At that time, I feel so fearful that I can’t gather courage to do the work. (HG: closed fists of both hands)

When we ask him about dreams he comes back to the same situation of this railway accident. His mind is so preoccupied with this fear of an accident happening at the railway platform and his incapability to handle it, that he just cannot think of anything else. And to add to his misery he feels that he is being pursued by journalists.

D: The press people reported everything right? What did they say?

P: They haven’t reported anything, they just come after me saying, “This man was there.”

D: What if they are behind you, what will happen to you?

P: Then I feel fearful. There are a lot of people, what will happen to us? Will any (legal) action happen against me? (HG: closed fists of both hands)… I don’t get sleep; I don’t feel hungry; I am feeling weak. This is how things have happened.

D: What thoughts do you get when you can’t sleep?

P: What will happen to me? What will happen to my kids if something happens to me? These are the thoughts I get.

D: What will happen to you, according to you?

P: Will they put me in jail? That is what I feel.

The main feeling is as if he has committed some big crime, and deserves to be put in jail.

D: What else can happen?

P: I feel only this much... I was recruited to fill my father’s place. My father died, so I was recruited in his place. I was not a police type - I have always been lean and thin. 

He reluctantly took up this profession when his father died at an early age. It happens in government jobs/posts in India that the son takes the place of his father after he reaches the age of majority. However, the patient did not wish to take this as a profession as he felt he would be incapable in such a career. Also, his body stature did not make things easier for him. He felt he was not at all fit for the responsibilities of a policeman. We see that this feeling of incapability has been there in him right since childhood, and the situation of the railway accident has just come to manifest who he really is! We are dealing with a person who is shy, timid, lacking courage and strength, and who also has the feeling of being pursued as if he had committed a crime. These are the two aspects of the case.

D: You said something about your childhood…

P:  I had typhoid and my body stature is not good.

D:  And mentally also you faced some problem?

P:  Yes, that was there.

D: What was there?

P: I wasn’t getting good stimulus to my brain, or my mind wasn’t working properly. I was studying but my brain wasn’t working. I couldn’t recollect what I had read. Somehow, I managed till the ninth standard. But then my father died, so I took up duties in his place.

D: What are you worried about?           

P: What will happen to my kids if something happens to me? That is what I am worried about.

D: What will happen?

P:  Who will take care of their education? The kids are still small. My son is in the sixth standard and my daughter is in the thirteenth standard. They are still small.

D: What might happen to you?

P: If they file a case against me.

D: What will happen if there is case against you? If we imagine that a case is filed, then what will happen?

P: I might go to jail.

D: Then? What happens in jail?

P: I have never gone to jail.

The patient’s wife says that he is constantly feeling that people are looking at him, spying on him and taking his photograph, and that they will report it to the press.

Understanding the case

When you look at this person, you see that he is feeling grossly inadequate. In whatever position or role that he has to perform; in that role he is grossly inadequate. This inadequacy becomes a basis for intense fear and anxiety in situations where he has to perform. So, what are the situations in which he has to perform? His role is of responsibility – it is in the role of policeman at the railway station who is in charge of managing the accidents that happen there. Now, can you imagine the job of managing those accidents? This job involves caring, understanding, managing the public, addressing their issues, coordinating with the right authorities, organizing the right stretcher and arranging for first aid so that the injured person receives proper care and can be taken to the appropriate hospital. In addition to all of that, there are legal formalities that need to be taken care of.

Now in this role, he lands up having to deal with an accident on a railway platform on his own, and he feels completely incapable of dealing with it; he just left the body there and ran away from the scene. He has the feeling that he has neglected his duty, and that now the press and the police are after him. He feels that a case is going to be laid against him, and he is going to be in deep, deep trouble. Because of this, he goes into a neurosis bordering on psychosis, where he starts hallucinating that people are looking at him, pursuing, and photographing him.  The feeling is: “They will show me in the media at any moment, and then the police will catch me.” He comes in an extremely neurotic state, with a tremendous fear that the public will beat him, or he will be arrested, and that he is constantly spied upon.

In what kind of person has this happened? One who is very simple and unintelligent. He has reluctantly landed in the profession of policeman. He always thought of himself as small, unsuited to take up such a profession. So, a person like him who is dull-witted, with a thin and emaciated physical build, is put in the job of policeman, a relatively high-profile job for his very small stature. He is so short of capability to handle this role that eventually he lands in this severely neurotic state. With this state, he feels a sense of danger, he sees strangers, he sees people behind him, he feels pursued – and all of this is happening to this person who has no daring, no strength, no courage, who always feels the need to have some colleague present so that he can do his job. Without his colleague he feels completely incapable. When a person who is small, dependent, weak and timid lands up in a circumstance where he has to take charge in a relatively high-profile job, this is Baryta.

Then, there is this other aspect of feeling he is pursued, in imminent danger, that people are following him, that he is guilty for being unable to do his duty, like a criminal, in acute danger which is just around the corner – this is an acute collapse of his entire being, his structure. This is the Bromium aspect. The bromatums have this feeling of being pursued, which can be best understood from Kali bromatum. It goes to a level of neurosis; neurotic fear is most prominent in Bromium among all the halogens. This quality has been seen in many cases in the literature, as well as in my cured cases, that people needing bromatums are highly neurotic. So, when there is a strong neurotic aspect in the case, one should consider the bromatums. 

So, here you have Barium – completely inadequate to perform the responsible job – and Bromium – extremely neurotic; feels that people are behind him; that somebody is pursuing him; that he has done something wrong; somebody is coming around the corner to catch him; along with acute panic.

Prescription: Baryta bromatum

From Jan Scholten, Elements of Homoeopathy:

Powerless to prevent mistakes

They feel they are always making mistakes, there is simply nothing they can do to avoid it, they are completely powerless. Even when they are doing well they still think they are doing it wrong. This feeling gets even stronger when they are faced with a new task. Anything that is new makes them feel out of control. New people make them feel more inferior and less able to cope.

He constantly has a feeling that he has made a big mistake of not doing his duty in the proper way and in such a situation he feels completely powerless. He is very cowardly; he has absolutely no courage to go and face such a situation.

Ridiculed for their mistakes

They are very afraid of being laughed at because of all the mistakes they are making. Even when someone just looks at them they think they are being ridiculed. Every mistake is bound to invite derisive laughter from everyone around. A typical situation where this feeling can be expected is in a school where they are newcomers and they have to learn how things are done. They need a lot of support and encouragement, because they are sure that the others think they are stupid. They can easily become the laughing stock of the school. They are incapable of putting up a fight against the school bullies, they might even attract this sort of situation. Later on in life they might come up against similar circumstances, where everybody at work takes the micky out of them because of their clumsiness.

There was a situation in which he failed to do his job and ran away, and now he feels people are watching him and taking his photograph and threatening to hand it over to the press. Also, in the situation of the job he cannot handle, he fears being bullied and beaten up by the public.

Delusions: superior, alone; mania, somebody looking over their shoulder, being pursued, fasting, becoming insane, travelling, ghosts.

His main delusion was of being alone and of being pursued, with an underlying feeling of guilt, as if he had committed a crime.

Follow-up after 10 months: there has been a remarkable improvement in this case of borderline psychosis, in which the patient was almost on the verge of starting antipsychotic drugs. His whole state has undergone a lot of change. All of his obsessive thoughts and fears have reduced by more than 70%. There are still instances where people try to fool him or scare him, but he feels much more capable within himself to tackle such situations. He feels eager to go and work, whereas he used to try to avoid it. The feeling of being a criminal has been replaced by courage and an increased sense of responsibility. He says with a smile on his face: “I gather courage to do my duty.” 

This is one of the beautiful outcomes of homoeopathy, when a patient who was previously dependent, fearful and incapable becomes courageous, independent and in charge of his own life. The similimum has a great potential to bring the altered vital energy to normalcy, in which the vital force rules in unbounded sway, restoring harmonious sensations and functions in the body, so that our reason-gifted mind can be utilized for the higher purpose of existence, as stated in Aphorism 9 of the Organon by our master, Dr. Samuel Hahnemann.

The patient’s appetite has improved, and he has put on a little weight. He looks much calmer, brighter and bolder. He has received a total of three doses of Baryta bromatum, once every three months. He still comes for follow-ups, but infrequently now, as his dependency on homoeopathy has reduced. He enjoys life and takes each day as it comes. It is most gratifying to have been able to help him, and to see a confident smile on his face.

This case has been previously published in VOICE: e magazine of the other song http://theothersong.wordpress.com/

Photos
Flickr; Churchgate railway station Mumbai; Bernard Oh; Attribution-NoDerivs 2.0 Generic
Flickr;Home guard guiding traffic with the Mumbai police; Harini Calamur; Attribution-NonCommercial-NoDerivs 2.0 Generic