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Case Study

Cases on Impulsive Compulsive Neurosis
Compiled and Extracted by
T K Kasiviswanathan
'Thuja / Cup-met / Lith-carb / Mang-iod

Case 1
Thuja thinks that he is made of glass, thinks he is brittle and cannot be touched. A middle aged woman used to pad herself with newspapers. When asked, she stated in a whisper that she was afraid of being touched and she was sure she would break like a glass. There was a suggestion that she should be sent to a lunatic asylum. Dr Dorothy Shepherd gave her Thuja 30 every 7 days and when she saw the patient a month later she was so happy. She had lost the awful sensation of being made of glass. There was no need to send her to an asylum. Thuja cured her rapidly.
Dr Dorothy Shepherd- Physician's Posy

Case 2
A 40 year old woman came for treatment for her enormous tension, anxiety, chronic coryza from which she was suffering for more than 8 years; pain in sacral region, tingling in finger tips, irritable and hard abdomen before menses. Pain in left shoulder for the past 3 years; heavy smoker- 20 cigarettes a day since 18y, with lots of coughing. Conflict with her daughter, who left her home, aggravated the tension. Desires cold drinks. She has a blue sclera and brown spots in her face.

Very tense and careful. Restricts herself to rules; she never crosses a red signal; very anxious in a car, fear of accidents, very conscientious in her work; routines, wants to keep things as they are; hard worker and always busy and wants to finish everything. Has to be ready at a set time and does everything according to a plan; fear of her boss and dare not ask for a day off. Aversion to be at home alone.

Cuprum-met in various potencies alleviated her many complaints and also her mental make-up.

The main points which should guide one to this remedy are:
The appearance of the patient: the combination of blue sclera, protruding eyes and swelling around eyes, both are characteristics. Secondly there is tension from anxiety and anticipation, overworking, fear of failure and mental, emotional and physical suppression. They try to control everything in a rigid manner, are fastidious and have great respect for rules. They feel better when occupied. Their anxiety for others, especially for the members of their family has been verified many times.
Dr Tinus Smits-Cuprum-metallicum-Homoeopathic Links 2/920

Case 3: Obsession To Check And Recheck
A 30 year old woman suffers from migraines. It starts with tension and pain in the neck, radiating to the corner of her right eye with stitching pain. Before it starts she feels very tired. The pain is worse at menses (3), light (2), stooping (2), coughing, damp and warm damp weather (2), sauna (3), ice-cream, lying in late, alcohol (2), relaxing in the weekend. Amelioration from: rest, lying still, pressure, kneading, motion, cold applications, lying on right side with head turned to the left, urination, aspirin.

She says her life goes from one extreme to the other, either she rushes around working very hard, or feels incredibly tired. She starts something with great enthusiasm, but after three or four times she loses interest. This is because she feels she isn't doing well enough. She takes things too seriously, everything has to be perfect the first time, and otherwise she loses interest. She is too restless to work her way through many trials and errors, she hasn't got the discipline to see something through. She expects a lot of herself in order to prove what she is worth.

But her self image doesn't fit the reality. She also has certain obsessive traits, like having to check the locks on the doors or checking and rechecking. The concomitant symptoms: cold hands and feet, pale face, sometimes nausea and vomiting, sometimes dizzy, feeling dejected and tired, aversion to company. At one time she saw many white spots and lost the right side of her vision in both eyes. The headaches are often caused by tension, like quarrels, exams, having people to dinner, meeting new people. The migraines started when she started her practicals for her Cesar therapy studies, this was too much for her because of having to make contact with so many people.

She is afraid of the future, afraid of getting ill and not being able to manage. Afraid of getting mad from all that worrying. She doesn't express her anger, unless it has really come to a head. She is mostly very shy, alternated with extrovert behaviour.

She has been living with her boyfriend for ten years but the relationship isn't very all that happy. They find it difficult to talk to each other and to share their problems.

The vertical hemiopia on the right side is a typical Lithium-carbonicum symptom. On the strength of this symptom, and because I couldn't think of anything else, I prescribed Lithium-carbonicum, although I didn't have much to go on.

Great was my surprise when it acted and I learned a lot about the remedy from this case. It wasn't until after she had taken the remedy that she told me the story about her father (carbonicum) and his all or nothing behaviour (Lithium). This alternation in mood made me think of the use of Lithium in psychiatric patients with manic depressive psychoses. This gradually enabled me to build up the Lithium picture.

Later on, I recognized some other beautiful Lithium symptoms in this case < tension, < new people, hurriedness alternating with tiredness, enthusiasm alternating with disinterest, feeling she has failed, restlessness, no discipline, lack of self-worth, obsessive, controlling, gloomy, > security, < adventure, no place for her, fear of the future, disease, becoming mad, shyness alternating with extrovert behaviour, menses absent, her father feels guilty, dream that half her parental home has been swept away.

After Lithium carbonicum 1M she gradually started to improve. The headache got worse at first, but afterwards better. She is mentally much stronger, more positive, doesn't get overwhelmed anymore. She is able to express her anger, or rather: she can no longer hold it in. She doesn't want to beat around the bush anymore in her relationship with her boyfriend. She is not so fixed on her goals anymore, less obsessed by the future, more content to stay with what is happening now. She no longer has to cling to securities so tightly.
Dr Jan Scholten- Homoeopathy & Elements

Case 4: Obsession To Help Out
A 40 year old woman has a large goitre. It is so large on the right side that one can hardly see her throat. It started after her two children had been born and it is worse before the menses. There had been many deaths in the family around the time when her children were born: both her parents, both her grandparents, her father in law and her uncle all died around that time. She took care of her parents until the very end. They were still relatively young: her brother and sister were only 13 and 14 years old at the time. She took it upon herself to look after her little brother and sister, but it was all a bit much, when she was pregnant.

She is always very busy; though she has to run her own household and look after her relations, yet she helps out other people. She works from 7 in the morning until 11 at night, always busy for other people. Her friends only have to ask and she is there, ready to help. She gives a lot and she receives a lot too. Apart from her part time work as housekeeper for another family, she also works at school, giving cookery lessons. She can hardly keep up with all these different activities and she finds herself doing several things at once. Her speech is hurried, as if she hasn't got enough time to tell me everything.

She can't stop herself anymore; there is never a moments rest. She can't stand being criticized. She does her best at all times, so there is no reason to find fault with her work. Everything is immaculate and running smoothly, but it takes a lot of energy to get it like that. She worries about the children, she panics when she hears an ambulance. She is quite possessive of the children, particularly of her little son. He used to be hyperactive and was in therapy for years. She feels she has to be alert all the time to make sure it doesn't get out of hand. She is afraid of the sea: doesn't like the shimmering brightness and the fact that it seems so endless.

Other Minor Complaints : pain in her shoulder and neck, worse from draught. Large varicose veins on the inside of her lower leg and knee, worse on the right side, starting after her first pregnancy. They feel hard and painful, worse before menses, better from putting her legs up. Her hands and feet feel numb on waking. Frequent swelling of her hands with pain, worse on the left side, worse on damp weather. She gets earache from draughts, and always wears a scarf when there is no sun.
Urticaria on face from bananas and tomatoes. Many problems around menses.

The goiter makes one think of Iodum, possibly Bromium and Fluorine. But Iodum is more likely in this case because she is so hurried and the goitre is more right sided. A typical symptom is her fear of the sea, the fact that it is so endless. We know that the sea also plays a role in Bromium and Chlorum, but the feeling that it is endless has something to do with the aspect of expansion, which belongs to the Silver series.

But which Iodum should we choose? Her work has to be perfect and she can't tolerate criticism. This points to the Ferrum series. She is always busy helping people: her parents when they were ill, her little brother and sister, the school etc. This leads us to Manganum and from there to Manganum-iodatum. She has to be alert all the time (Iodatum, things might get out of hand at any moment) in order keep everything running well (Ferrum series).

Another nice example of the two elements combined: she gives cookery (food, Iodatum) lessons (Manganum) Further Manganum symptoms: earache << draught and wind, > scarf, < tomatoes.
Iodum symptoms: hurried speech, <<< death of family, warm, < sea, > outside, > solid food.
DD: Ferrum- iodatum, Calcarea- iodata, Arsenicum- iodatum.

Reaction: One week after Manganum-iodatum 1M she got an aggravation that lasted a week. Afterwards she feels better. She doesn't do ten things at once anymore, is less hurried. One year and several doses of Manganum-iodatum 1M later she is doing very well on the whole. Her goiter has disappeared and she feels well.
Dr Jan Scholten- Homoeopathy and the Elements