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Case Study

Why I could not achieve?
Dr Vishpala Parthasarathy

As we have seen, Anxiety is the curse of a professional life but when it reaches panic attacks, it messes up your career graph. Promotions are rejected to avoid added responsibility and pressure.

I remember a case of Dr Sonawala's, where the man opted to remain a clerk all his life, because being an officer would entail responsibility. For him even a sexual act was a tension. Next day he would present himself at the clinic, with stomachache, backache or even diarrhoea!! This was an extreme case, and I do not think he improved much, because he did not want to improve. Anxiety was a shield to keep him at bare existence level.

But in a second case, the patient had normal ambitions & yet let go every other promotion, because it involves more presentations. Stage-appearance was synonymous with panic attacks. Then in a third case, it interfered with life to the extent of giving the patient - hypertension and giving his son acute school phobia; thus producing 2 patients from one situation. These certainly cannot be left alone, and maybe Homoeopathy is the answer. Where it is not possible to change the environment, there too it is possible to help: counseling and Homoeopathy are a potent combination. But each case will get well on its own merit and on its ability to adapt.

For this issue, the second case is going to be discussed step by step, the grappling with the selection of the remedy and of course the resultant amelioration. WITHOUT ANY CHANGE IN THE ENVIRONMENTAL FACTORS.

A young man of 42, but looking much younger, came in early '98. At first sight I tagged him to be about 35. He had come down from USA, primarily to consult me for his PANIC ATTACKS. There were no physical complaints. This makes it easier; you know you are dealing with pure, pathological anxiety. There is no ambiguity. Patient also knows that he has a psychological problem for which he needs help and will have to bare his soul, tell the whole history, to get proper help.

History: Straight on I ask him to detail his life situation right from the beginning. He narrates the entire story, comprehensively with little interruption from me except to clarify or nail down points. It took almost an hour but the picture evolved clearly. I am going through the interview exactly as it happened, and will put in brackets my conclusions and comments, so that by the end of it you know the exact thought process & the solution.

The Story :
He is younger of 2 sons. Father hails from Karnataka, educated in the UK; after which he came to Bombay in 1954, for a job with an Advertising firm, met a Maharashtrian girl, a PhD, working with Indian Women Scientists Association. They fell in love and got married in 1956. First son born in 1957; second, our patient, in 1958. Family was complete.

Father had firm views on sons' upbringing and applied for boarding school in 1958 itself. Father was a bit of a recluse, introvert, angry and moody. Mother was the opposite - sane, cool, outgoing and the cementing force of the family. Happy childhood. In the 4th standard he was sent off to boarding school at Ajmer. Brother was already there. Remembers being homesick. Gradually settled down and liked Boarding, yet holidays at home - both summer and winter - were major happy events. In addition, once a year the parents would come down to Ajmer. He was good in studies and school-life was generally good.

[At this point, he remembered one recurrent bad period, covering the fortnight preceding holidays, which was buried deep in his consciousness] They never had a phone at home. His father, being the recluse he was, hated having one. Fa's motto was give your best while in office and cut off when go home. Therefore, through all his promotions, he persistently refused a phone at home. At their social strata, this was a source of acute embarrassment to our patient. This would surface just before term end, when children would start exchanging Tel nos with promises to keep in touch during holidays. As this period approached, our patient would become withdrawn, avoid contact with others and keep to himself; all so that he would not be asked to give his Tel no. [Tendency to avoid or not meet problems head on; to be drowned by problems, and let them remain unresolved, began early in life]

"How did your brother tackle this?" I asked. 'Oh! Very normally. He would just tell people 'you know what a quirk my old man is - refuses to have a telephone in the house. So give me your Tel no and I'll call you'. This little event aptly highlights the major difference in the 2 personalities - just like in the father and mother. Except that our patient is a better version of the father - pleasant looking, very polite, and able to talk freely about himself. [At each stage, I make it a point to explore family-relationships and attitudes, to understand the dynamics of the situation and the evolution of the personality and his responses to specific situations. I call this nailing down.]

To continue with unfolding of the life events:
Br always had a large circle of friends,, which our pt would clamour to join, and Br would avoid. Thus they went through school. Br finished in '74 and pt in Jan'75. Meanwhile in Oct '74, Mo was deputized to Germany for 2½ yrs; she went with Fa's encouragement. After ISC, pt spent 6 mths with Mo in Germany as he had holidays before colleges began. Family holidays and small excursions around Germany on his own, contributed to his growing up. It was a Fun period. Br was already in college so could not come for a long period. In June '75 he returned to Bombay and joined Sydenham College. For those 2 yrs, the house was run by servants for cooking and washing. Fa held the purse strings but was clueless about actual costs. Boys left after breakfast and came back only at dinner, to avoid long periods with Fa - moods and all!

1979 he finished BCom. The final year he did by correspondence, since meanwhile he had developed a passion for flying and joined a flying club; was quite involved in it and had no time to attend regular college. Later he quit flying, as it was a risky hobby, and if something did happen, his parents would be shattered. [Consideration for other's feelings. This comes up often in his life.]

79- 80: Went to US for MBA. All friends going, Fa agreed to let him go. The first year in America and freedom, he went wild - just partied, and wasted a term. But second term on, he belted in and finished MBA - taking 3 instead of usual 2 yrs! [Felt a little ashamed while telling us] One school friend of his was with him and till today is his close friend. [He has only few friends and maintains the friendship. Never breaks off.]

Jan 82: Got involved with an Indian girl in the US - very intelligent and attractive. Gradually as time went, he felt it wasn't quite right. She was older by 10yrs and so at a different stage in life. But she did not want to let go. Why? I asked. Maybe she liked my personality, etc. Why not just say she loved you? Yes, I suppose. [Cannot say exact truth and suffers from inaction.] At this point in 1984 he started getting panic attacks - sudden rush of blood, adrenaline pumping, as if head would burst. Happened especially when he went into tunnels, over bridges and on stage.

Met 2nd girl - again Indian, attractive, intelligent 3 years younger and from MUMBAI. Being from the same city further clinched it as THE PERFECT MATCH. Finally he had to break up and managed it amicably. This was 1985. [So he had to met 2nd girl and this initiated the process of breaking up. My gut feel is he needs one ongoing relationship at least.] This girl also was aggressive, chased him and was instrumental in the break. I didn't ask all this - I just asked if she was aggressive? Yes she was. [Again feeling of guilt in hurting Girl 1 by the break; considerate, does not like to hurt others.] Even after the break, panic attacks continued, though they did become less frequent.

1986: Engaged. 1987 married. But things did not work out so well. She was a women's libber and would get into many arguments, even though he was hardly an MCP. His own background was progressive - having a scientist mother does not speak of a MCP background. Yet wife had major differences & arguments became a common feature. All this changed our pt too; he started getting angry and a little recluse, like father. Eventually, in 1988, she just walked out one night, and he never saw her again, though he called her brother and said he needed to talk to her.
[Hates being hurt, hates breaking up a relationship. Marriage is forever. Good solid values.]

After that for 4 yrs he was too devastated to even date, leave alone start another relationship. Had a recurrent dream that he met her and asked her WHY?
Gradually he got into meditation and philosophy, the Ganeshpuri Ashram. There he met Liza in 1994, who was an American and just a tremendous person. Gradually got close and today they are married and very happy. The day he married Lisa, this dream vanished.

1985 - 94: Panic attacks on every tunnel, bridge or stage.
1994 - 99: Panic attacks less, but persist while public speaking or driving through tunnel/ bridge with colleagues or strangers. Not with wife, with whom he is tremendously comfortable. She is kind, genuine and giving with good values (unlike wife1 - very social strata conscious). Liza works with a non-profit organization for old age programmes. Very content; has been with same organization for no. of yrs. Pt's Career is good, but held back at Director level, not VP level. Has changed many jobs. Even now wants to do a project for India. Very ambitious. All ambitions not achieved.

Past History - Inguinal hernia '79 operated. Undescended testis - operated '85. Semen analysis explained sterility. No worry. But when I suggested adoption he said he would look at adoption options, now that he is in India, as Liza may like children.

Family History - Mo: Hypertension, Diabetes; MGF: Ca stomach.

So what strong traits have we got so far?

·         Homesick

·         Embarrassment

·         Loner

·         Introvert

·         < Public Speaking

·         < New undertaking.

·         Claustrophobia

·         < Crowds

·         < Trapped

·         Recurrent Dream - Not able to catch plane. This was when went to USA before got Green card and could not leave country. Dream vanished when came to India. 2nd dream was about meeting wife.

So what are the remedies coming to your mind, and how are you going to differentiate them?
Basically, pt is considerate & affectionate: I could not get the rubric considerate.
AFFECTIONATE: PULS, Phos, Nat-m, Nux-v Carc, Ign, Crocus, Ars, Lach, Lyc, Sil
Homesick: Aur, Bell, IGN, Caps, Caust, Clem, Cocc, Caust, Lach, Nat-m, Phos, Puls, Sil
FEAR CROWDS: same as claustrophobia
So the group of remedies which come out is: Arg-n, Ign, Lyc, Nat-m, Nux-v, Sil

First let us eliminate the remedies, which don't fit at all: Puls or Phos - pt is just not social enough
Arg-n: there were no general fears at all in childhood - of height, dark etc.
His fears have developed in adulthood due to circumstances.
Not Nux-v: thou ambitious, not that drive or irritability.
I had narrowed down to 2 remedies: Nat-m, Lyco
Introvert: is not there but another rubric: Introspection is probably more indicative. Pt told me he often does self-analysis. This explains his very coherent history.

Ro 1068

Introspection: Lyc

Ro 1038

Emotions AF strong Lyc

Ro 655

Anticipation AF, fear of failure with: Lyc

Ro 997

Anticipation, Arg, Nat, Lyc


Lyco 1M given. Same day he had tremendous diarrhoea. From 3rd day he felt the all-pervading anxiety, which he always carried around from as long as he can remember, starting to ebb. The tide had turned. He continued to improve with a little help thrown in occasionally - by way of Lyco. Today he has no fears left. His career graph is also beginning to show that upward trend.