It took me nearly two decades to realise something obvious about classical homeopathy - the conversations we have with our patients are the most important part of the whole process.
Why is this so obvious? Picture in your Land a homeopath who has an encyclopaedic knowledge of the materia medica, an intelligent and flexible approach to case analysis, including the use of computers and a comprehensive, homeopathic library. However, this homeopath is simply not very good company. Patients feel slightly uneasy in his consulting room and his friends and family have always found it a little hard 'getting through' to him.
Now picture in your mind another homeopath. This one is the sort of person everyone just can't help opening up to. He is just so understanding and sympathetic. Such a good listener. His only problem is that he doesn't know much about homeopathy. He knows what sort of information you need to get from your consultations but as for the materia medica, well, there are just so many remedies, how on earth can anybody expect him to remember any of them. As for books on homeopathic theory, they are just so hard to read.
If you had to make a choice, which of these two would you consult? It has to be the latter for one good reason. The homeopath who is able to take good case histories at least has a chance of finding your remedy. He is able to leave the consulting room with your main symptoms, in particular your emotional profile. He can use repertories, computers and the materia medica to help him find a remedy to match what he knows about you. He can phone up a colleague, better versed in the materia medica, and ask for advice or take your case to a supervision group.
As for the former homeopath, I guess he will be left wondering why he doesn't have much of a practice considering the thousands of hours he has spent studying homeopathy. And why do his remedies just not seem to work? He knows their drug pictures so well. Why can't he find any patients to fit them?
The sad truth is that such a 'homeopath' might as well give up homeopathy and go and study surgery or massage. Maybe his talent always was in his hands.
People become homeopaths for different reasons. Some are so grateful for what a remedy did for them that they become determined to study this amazing subject. Others are fascinated by homeopathic theory. There are those who are smitten by the idea that every mineral, metal, plant, poison or animal secretion has specific healing qualities that can potentially be matched to the whole of the patient physically and psychologically. There are even those, like Hering, who studied homeopathy in order to refute it but ended up falling in love with it. Few students of homeopathy choose the discipline because they are good listeners and enjoy talking to patients.
The ability to listen well and say the right thing at the right moment is central to the homeopathic process. It is surprising that so little has been written about taking the case and the homeopath-patient relationship.
This book is an attempt to draw attention to what actually happens in the homeopathic clinic. To do this it is necessary to examine what is going on in the mind of the patient, the mind of the homeopath and in the space between them. Although homeopaths have not, until quite recently, focused on the practitioner-patient relationship, the disciplines of psychotherapy and counselling have always recognised that relationship to be a vital factor in the prognosis of the patient. It is the contention of this book that this relationship is even more vital in homeopathy, not only because we have less time to spend with our patients than counsellors and psychotherapists do, but because the reward for effective communication between homeopath and patient is the prescription of the correct remedy.
The value of the correct prescription is inestimable and yet it is not the only reason for learning to have more authentic conversations with patients. The syndrome of 'burnout' is far from uncommon among homeopaths. Many of us end up feeling drained by our patients. It can be a heavy burden being a homeopath. We know the potential of our remedies but we have to live with the shadow of feeling guilty about patients suffering because we have not been able to find the right remedy. As we learn to have more meaningful conversations with our patients, this guilt gradually diminishes and the responsibility for finding the remedy begins to be shared by homeopath and patient.
I have written this book for fellow homeopaths and homeopathic students alike. We are all students of homeopathy and I have yet to meet anyone who claims to have mastered the materia medica or the taking of the case. It takes decades of both study and clinical practice to make serious inroads into the materia medica and there are no short cuts. The study of books on homeopathic theory, especially the Organon, can be inspiring, but are only fully appreciated after many years of consulting.
Fortunately, when it comes to taking the case, I feel that it is possible to make some progress quite quickly if the teachers and students of homeopathy choose to focus on this aspect of homeopathy from the very beginning of any course of training. If anything, it can be a lot more fun than trying to memorise the materia medica. Taking the case should be of equal interest to us all. Experience in the clinic is the greatest teacher, but when it comes to communicating with patients, it is quite possible for the `master' to learn something from the 'absolute beginner'. This is because authentic conversation is more about life itself than it is about the homeopathic consultation.
This book is the result of a long, personal journey of exploration into anything that I felt could help me communicate better with patients. This journey included forays into psychotherapy and psychoanalytic theory, counselling, philosophy, and, of course, what both homeopaths and orthodox doctors had to say about the practitioner-patient relationship.
Brian Kaplan's 'The Homeopathic Conversation' is unique as to my knowledge it is the only book which focuses on the art of the homeopathic consultation. This is surprising, given the fundamental importance of consulting, history taking and observational skills to homeopathic practice.
Dr Kaplan covers the field comprehensively. His open and relaxed style mirrors a good homeopathic consultation. But it is deceptive, as behind it lies a great depth of knowledge, experience and scholarship, which he generously shares with his readers.
He starts with an autobiographical account of his own (rather alienating) experience of medical training and the intercontinental journey of discovery which brought him to the Faculty of Homeopathy in London. He then moves onto the core of the book; the art of homeopathic history taking.
The Homeopathic Conversation' is laden with sound advice, from the dangers of telephone consultations on acutely ill children to the importance of smiling at your patients. It presents a well centred and grounded view, gently warning against the excesses of some modern schools whose view of homeopathy is dominated by mental symptoms or other, simplistic versions of homeopathy.
Instead he emphasises a pragmatic approach to the fundamental skills of talking to and observing our patients. There is a whole chapter devoted to one of the most important, but difficult to teach, aspects of the homeopathic consultation. I call this 'not what they say, but how they say it': the non-verbal clues which, to an experienced practitioner, can be decisive in prescribing. There are helpful suggestions for paperwork, every practitioner will want to adapt it, but these are helpful starting points. He offers sound advice on some of the most difficult parts of the process of homeopathic treatment including time, appropriately in the final chapter.
But Brian's greatest strength is his psychological background. He has a deep understanding of Freud, Jung and the enigmatic and ultimately tragic Wilhelm Reich. He is influenced by the existential psychotherapists, including his mentor, homeopath, philosopher and psychotherapist, the late Dr Eric Ledermann. But perhaps his greatest influences are psychologist and psychotherapist Carl R. Rogers and particularly Frank Farrelly, the founder of Provocative Therapy which is the clinical application of reverse psychology and humour in psychotherapy. Brian is well-known in the UK for introducing Farrelly's technique of ' therapeutic provocation' into homeopathic practice. For a sample, try the last page of chapter 13; three quarters of the way down the page your blood will be boiling, but by the time you reach the bottom, you will be thoroughly disarmed!
I commend The Homeopathic Conversation' to all students and practitioners as a wise and practical guide to some of the most basic arts of homeopathy.
**Contents and Sample Pages**
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