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2013 March

I bury my head in the sand: a case of Venus mercenaria

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by Carolyn Burdet

Woman age 56. Presenting complaint: Post traumatic stress, anxiety, panic attacks, insomnia, eczema, allergies.

The first impression of this lady was of a sad looking Botticelli’s Venus, 30 years later. She has incongruously long, fair hair, and she wears a loose formless dress. Her unstructured appearance is a surprise. I met her briefly 10 years ago; she had short dark hair and wore a dark trouser suit. She seems downhearted. She sits impassively with her arms clamped across her abdomen. The impression is of softness.

She has been suffering from “post traumatic stress” since a car accident on the motorway six years ago. The accident happened within a few months of the terrorist bombings in London. She missed the explosions by minutes. “I know this is irrational but I felt they were aimed at me.” The aftermath of the shock was a nervous breakdown. She was unable to sleep, suffered severe panic attacks, with palpitations, and became phobic about being in the city. She took early retirement from her career as a partner in a corporate law firm.

She lies on the sofa by day, unable to sleep at night, woken by the slightest noise. If she thinks it was inconsiderate, she cannot get back to sleep.

She retreated to her rented cottage in the countryside on the weekends. She wanted peace and quiet, was aggravated by noise or company, becoming irritable and critical (DD Nux vom). She was deeply unsettled when the owner decided to sell up. She moved into a relative’s home ‘temporarily’ and has been procrastinating about dealing with negotiations to purchase a new home.

“I can’t face dealing with anything financial or legal. I stick my head in the sand about anything official. If I see an official envelope, I can’t open it. I have a panic attack, I get palpitations. I won’t open it.”

She has been drinking 6-8 cans of fizzy caffeine drink daily but claims caffeine has no effect. It does not give her an energy boost but she cannot sleep at night. She has been taking “a cocktail” of over the counter drugs: antihistamines for allergies and sleeping tablets.

The eczema started 18 months ago when she was told she had to move out of the cottage.

It started on her ankle and spread up her leg and all over her torso on her back and tummy. It is a red rash of dry vesicles: “It’s itchy and irritating, like damp sand.”

She describes the panic attacks if an official envelope arrives: “It’s an adrenaline rush, your heart beats frantically, cold sweat, you hyperventilate, as if you’ve had a sudden shock. It’s a horrid feeling that something dreadful will happen.”

She is not married and did not have children, but she takes financial responsibility for relatives’ children, paying their household expenses and funding them through university. 

She “worries herself sick reading health textbooks.”

She misses the intellectual challenge of work and reads “gentle, clever” novels “as a distraction” from the things she puts her head in the sand about. “I don’t watch the news, I can’t bear knowing about the horrible things that happen. I have to shut it out. I empathise too much... Those poor people in the earthquake in Assisi who lost their homes.”

She does not express this sympathy aloud. She hides this soft-hearted sensitivity behind irritation. She is extremely private and declines to discuss areas of her life that are personal. “I can’t bear it when dog walkers chat to you and ask all sorts of personal questions. It’s very intrusive. I get irritated. Before you know it, an absolute stranger has told you about their children and they’re asking you where you live.”

After living at her relatives for a year, she craves her own space. “I’m in limbo, I can’t make any decisions until I am in my own place. I like the isolation.”

She mentions sibling rivalry over the best teeth and fingernails. She says her sister envies her nails which are sharp and strong, although she didn’t drink milk as a child. She dislikes damp, cold, cold air, drafts, and exercise, “I’ve got weak ankles, they flop over all the time.”

She recalls a childhood incident: “I was a good swimmer but the water was so strong, I was swept away by the waves. Because of the undertow, I couldn’t get back to land. I had to grip onto the beach in the surf to get onto the beach.”

I expected her to say it was terrifying - she had described panic attacks at the thought of opening a letter. But she becomes animated; it’s the most energy in the case.

“It was exhilarating. I loved jumping in the waves, massive waves of the ocean. I’d cut through the waves, come out the other side. The wave flings you out onto the shore.

“I hate being on the sand, sand gets everywhere, sand gets into the crevices and itches (HG: she starts scratching her eczema on her ankle). Damp sand sticks to my feet, it gets on my skin, it rubs and hurts you. It’s all-pervading, it makes your teeth stand on edge. If it was warm and sunny, with dry sand, I wouldn’t mind so much. Damp sand irritates my skin.

“I know, I’m procrastinating, I tend to drift along. I don’t face up to it. I just can’t face doing things. I pretend it isn’t there. I bury my head in the sand.”

                                                                                        

Prescription: Venus Mercenaria 200C

Follow ups
One month: the patient has had dental treatment she’d been putting off. She usually needs sedation for panic at the dentist. She is disturbed by the unpleasant sensation of gargling with salt water, as the saline squirts through the hole from the tooth extraction into her sinuses and nose. Squirting water through a siphon is speaking ‘clam language’!

She has stopped caffeine drinks, with no withdrawal symptoms; stopped taking sleeping pills and antihistamines, no allergies, and she is sleeping better. The eczema has receded downwards. Her skin is no longer itchy.

Six weeks: she rented a cottage on the beach for a seaside break, going for cliff walks. She is more energetic than she has been for years. She never liked exercise, and she was too fearful of twisting her ‘weak ankles’ to attempt a steep walk. She is more confident about driving. The thought of driving on the motorway had set off panic attacks since the accident. She is less irritable, more tolerant of company. She has a cold which is “mildly irritating, not debilitating” (people around her are in bed with ‘flu). 

Two months: she is still staying with relatives - it’s a year longer than they intended. She knows she has to face up to moving house. There’s anxiety about facing the legal correspondence. She has not been opening official letters. I sense she needs extra support from her remedy.

Prescription: repeat Venus Mercenaria 200C

Three months: not anxious about moving house, she has been in touch with solicitors, vendor, the purchase is going ahead. For the first time she mentions being overweight; she put on a lot of weight during 6 years of inertia (25kg). She will tackle her diet and look at doing an MA in literature when she moves to her own place. Looking forwards!

Four months: setback. A family pet died on her lap. Protective of her family, she is providing for them, but she has had to face financial realities, which scared her. She was sleeping badly after the death upset her - she took a sleeping pill, and since then her skin has been itchy.

She is low. She says she has always felt life is a bit pointless.

Beneath the irritation and anxiety, another level of the Venus remedy state is revealed. David Johnson says Venus has ennui, boredom, depression. She has no career, no job, no social life, no passion, and she is facing up to leaving this family home. Isolation relieved the stress of overwork and avoided the disturbance of other people’s noise, but isolation is no longer enough for her. She needs something to look forward to. I sense she needs more in her life. Grief, financial realities and the sleeping pill have aggravated her symptoms. But beneath this, there is progress as the stasis has been stirred up. She is taking her head out of the sand and facing up to life.

Silent grief looks like Nat mur (basis for so many sea remedies); worrying about finances looks like Calc carb. but she does not mention her own security, she is concerned about providing for her relatives without having to take her head out of the sand and look at budgeting. She “wants to shut it in a box.” This is Venus!

At this point in Geoff Johnson’s Limpet case, he gave a higher potency: 1M after a death was a setback (see this issue of Interhomeopathy). It makes sense to repeat or go higher potency, yet I sense 1M would be too much of a push for my Venus. She is feeling vulnerable; I want to treat her gently. I take the physical symptoms as a sign from the symptom maker to stay with a lower potency, then work back up to higher potency.

Prescription: Venus 30C, daily for a week

Two weeks later: she has booked another vacation by the sea to look forward to. She is moving forwards with her house purchase, and making progress with life. 

This is very early days in the case, it will take longer to reach a full recovery and express her creative energy, but after adrenal burnout and six years of anxiety, panic attacks, avoidance and inertia, she has made remarkable progress in a short period of time, and is taking steps back into the world, facing up to practical realities and taking an interest in life by planning enjoyable trips. 

Analysis

This is almost a Calc carb case, with a few differences and interesting hints of the complementary remedies to Sepia: Nux vom and Nitric acid. Predator / prey is not an emphasis in this case, but a touch of rivalry over teeth and nails points to the animal kingdom. She is sensitive to environment but there are no hand gestures or polarities of the plant kingdom, no mineral lacks or deficiencies. It’s all about Mollusc themes: soft hearted inside/ harder exterior, threat outside / protection of home, shutting out horrible things. Sea words come in waves, and the energy is in the description of the Source, cutting through the waves, burying in the sand.

Venus mercenaria is a Clam. A soft-bodied bivalve mollusc, it closes its shell for protection. Like Calc carb, Venus mercenaria as a remedy picture is sensitive to impressions, affected by sad stories, horrible news, shuts it out; averse to change, disturbed by having to move house. Ailments include: panic attacks, irritation, noise agg.

Eczema and skin irritation is a way this irritation is shown. My Venus case described the skin rash as irritating like “damp sand on your skin”, “damp sand in your crevices”. The clam buries itself in the sand and a person who needs this remedy, has an inclination to “bury their head in the sand,” procrastinate, reluctant to face up to things they have been putting off.

Rubrics lead to Calc carb in repertorisation, then it is a case of looking at remedies that share the themes. Venus mercenaria craves isolation (Calc carb enjoys the untidy warmth of family). Just as a clam closes tightly, ‘clams up’, to shut out disturbance, the proving shows the Venus state has an intense sense of privacy, resenting intrusion, averse to questions. They prefer peace and quiet, like oyster’s Pearl, except while the Pearl person feels overwhelmed, claustrophobic, unhappily isolated and crushed inside her shell, the Venus person craves his/her own space and total isolation.

Clam shells were used as wampum, a currency to sign a treaty, deal or agreement in traditional cultures. Venus Mercenaria is more ambitious than Calc carb, high earning and successful, generous in providing financially for others. In this Venus case, she dealt with legal contracts for years but in a burnt-out state there was a “head in the sand” avoidance of dealing with financial / legal matters.

Curiously, clams change gender from male to female during their life time. A person in the Venus state may spend the first part of their life in a ‘man’s world’ in their career, then change lifestyle. There may be some ambivalence about traditional male / female roles.

Whereas oysters are fixed to one place, clams swim, cutting through the waves. It lands on the beach and buries itself in the sand. It squirts water through a siphon when it’s disturbed.

Squirting water (from a hole left by a tooth extraction, into the sinuses and nose) was an unexpected indication of the patient speaking in confirmatory ‘clam language’ after the remedy.

Photo: Wikimedia Commons
La nascita di Venere by Botticelli; public domain


Keywords: bury head in sand, sea, waves, swimming, protection, privacy, irritation, shut the box, shell, bivalve
Remedies: Venus mercenaria

This article was originally published in www.interhomeopathy.org

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