HOW TO TEACH PSYCHOLOGICAL MATERIA MEDICA

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HOW TO TEACH PSYCHOLOGICAL MATERIA MEDICA

• Dr. K. M. Dhawale
• ROTP-PALGAHR
• 26TH FEBRUARY 2008

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PLAN OF PRESENTATION

• WHAT IS PSYCHOLOGICAL MATERIA MEDICA?
• INVESTIGATE THE CLINICAL ORIGINS AND BUILD THE
  PSYCHOLOGICAL PROFILE
• CONSTRUCT THE PSYCHOLOGICAL PROFILE OF THE REMEDY
  THROUGH A STUDY OF THE SOURCE BOOKS
• COMPARE THE CLINICAL STUDY WITH THE STUDY FROM
  THE SOURCE BOOKS
• APPLY THE UNDERSTANDING GAINED TO CLINICAL
  APPLICATION

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ThinkingFeeling
R E S U L T
ACTION
COMMITMENT
FEEDBACK
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CATEGORIES FOR PSYCHOLOGICAL ANALYSIS
1. MENTAL SYMPTOM/S 2. MENTAL STATE 3. MENTAL
DISPOSITION
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MENTAL STATE

• A combination of Circumstances or Attributes
  belonging for the Time being to a certain person
  or thing
• A Particular manner or way of existing as defined
  by the presence of certain Circumstances or
  Attributes

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MENTAL STATE
INTELLECTUAL
REACTIONS
EMOTIONAL
I M B A L A N C E
ACTIVITY
BEHAVIOUR
A C T I O N
EVIDENCE
INACTIVITY
FUNCTIONING
FAMILY
DISSATISFACTION
SOCIETY
WORK
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I.P.R. -------- STATE EFFECTS NATURE
XSTRAIN
? BALANCED ERRATIC
Jealousy
When teased
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EMOTIONAL STATE
CAUSATION CHARCTERISTICS / INTENSITY
ANGER IRRITABLE FRETFUL EXCITABLE   VEXATION
INDIGNATION   IRRASCIBLE QUARRELSOME
ABUSIVE RAGE FURY VIOLENCE OBJECTS /
PERSONS   IMPULSIVE WEEPY   SUPPRESSED
MORTIFICATION   HATRED / MISANTHROPY   REPRESSED
GUILT    
SADNESS
MOROSE, GRIEF, SORROW, INDIFFERENCE,
ENNUI   AVERSE WORK / PLEASURE,
QUIET   HYPOCHONDRIAC / MELANCHOLY   BROODING /
DIS-SATISFIED   ESTRANGED / REMORSE /
ANGUISH   SELF-PITY / DESPAIR / SUICIDAL   SEX /
ALCOHOL / SQUANDER   DEPRESSION
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LOVE OBJECTS HATE
CRITICAL CENSORIOUS CRUEL   MALICE SLANDER
REVENGE   OBJECTS   PERSONS   RELATIONS   WORK   S
ADISM PLEASURE   MISANTHROPY   ENVY
AFFECTIONATE / SYMPATHETIC   ATTACHEMENT SELF /
PERSONS / OBJECT MONEY / POWER / WORK /
CAREER   ROMANTIC / SENTIMENTAL   SEX
MASTURBATION HOMOSEXUAL SELF-LOVE   HETEROSEXUAL
PREMARITAL / MARITAL / EXTRAMARITAL   LEWD
GESTURE SONG TALK DREAMS   EGOTISM PROUD RUDE
CONTEMPT ARROGANT IMPERIOUS   JEALOUSY SUSPIC
IOUS  
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FEAR FRIGHT ANXIETY
ANTICIPATORY
ANXIOUS   NERVOUS   WORRY   TIMID   STARTLED   GU
ILT   RESTLESS   SLEEPLESS   AUTONOMIC
IMBALANCE ENDOCRINE SOMATIZATION  
DEPRESSIVE
AGITATIONAL
INSECURITY
DREAMS
BEHAVIOUR

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• INTELLECTUAL STATE
• (FORMULATION)

CAPACITY PERFORMANCE
PERCEPTION MEMORY
THINKING
ACUTE CLEAR CONFUSED
DULL   ECSTASY ALTERED   CLAIRVOYANC
E HALLUCINATION   VISIONS
ILLUSIONS   STARTS
LOSS WEAK SHARP   IMMEDIATE   RECENT
FANCIES   REMOTE   PATCHY   TRANSIENT
ACTIVE   EMOTIONAL   FANCIES / DAY
DREAMS  REVERY   ABUNDANT   FIXED   GRANDIOSE /
UNREAL
SLUGGISH   LOGICAL   DIFFICULT   SYSTEMATIC   PATH
CY   CHANGEABLE   PRAGMATIC
DELUSIONS IMAGINATIONS PERSECUTIONS ? ACTION
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C O N S C I O U S N E S S
DECISION
CONFIDENCE
DELIRIUM DULL COMA   ACUTE STUPOR   SOPOR  
ABSORBED   CONTRACT TIME   RECOGNITION PLACE  
RESPONSE PERSONS       ORIENTATION
HASTY PROCRASTINATION   OBSTI
NATE CHANGEABLE  
IMPULSIVE   CONTRADICTORY
IRRESOLUTE   CONTRARY
INDECISIVE
POOR ADEQUATE   SHAKY EXCESSIVE
  PERFECTIONIST UNRELIABLE   CENSORIOUS APPRECIATI
VE   GOAL-ORIENTED PERSON- ORIENTED   TYRANT
WEAK   PERSON
WORK
GOOD JUDGEMENT POOR
MOTIVATION WILL DRIVE
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PRECOCITY PERFORMANCE LATE SENILITY
SCHOLASTIC   SPORTS ATHLETIC   ARTISTIC   FAMILY  
MARITAL   SOCIAL   RELIGIOUS   WORK
EFFICIENCY   SATISFACTION   PROBLEMS
ADJUSTMENT / CONSCIENCE / POSITION
BLOCKS
MOTIVATIONAL   INTELLECTUAL   OPPORTUNITY   EMOTIO
NAL   INTER-PERSONAL
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3. REACTIONS A.F., lt, gt STATE EFFECTS
EMOTIONS
DISAPPOINTMENT LOVE   GRIEF, LOSS-LOVE OBJECT,
SORROW   BROODING, PAST, SELF-PITY   COMPANY,
CONSOLATION, WEEPING   FEAR, FRIGHT, SHOCK,
WORRY   ACTION, CARRIED, LOOKED,
MOTION   MOVEMENT, ROCKED, TOUCHED,
WALKING   NARRATING ALONE, WHEN
ANGER, EXCITEMENT, JOY, VEXATION   ENVY,
JEALOUSY, HATRED, PERSONS   CONTRADICTION   ANTICI
PATION, ANXIETY, APPROACH, BAD NEWS   CHAGRIN,
FRET, REPROACH, SCORN   ADMONITION, INSULTS,
MORTIFICATION   REPRESSION   INSECURITY, THREAT
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LIFE-SITUATION
INTELLECTUAL ACTIVITY
MENTAL EXERTION   SPOKEN TO, READING   THINKING  
FRUSTRATION   COMMUNICATION BLOCK
PERSONAL       FAMILY       WORK
SOCIO-ECONOMIC-POLITICAL-CULTURAL-RELIGIOUS   ILLN
ESS SELF / OTHERS   ADAPTATION
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SPEECH AVERSE CENSORIOUS CONFUSED CU
RSING DELIRIOUS   EXCESSIVE
FOOLISH HASTY INCOHERENT
IRRELEVENT LOUD LYING MONOSYLLABIC
NONSENSE OBSCENE PRATTLING
REFUSES REPETITIVE RUDE
SINGING SLIPS SLOW SLANDERING SLU
RRED STAMMER UNRESPONSIVE
WANDERING
BEHAVIOUR AGGRESSIVE ALTERNATING CHANG
EABLE CONTRARY DANCING  
DESTRUCTIVE ERRATIC EXTRAVAGANT FASTIDIOU
FRIGHTENED GRIMACING HOMESICK HU
RRY IMPATIENT IMPETUOUS  
INACTIVE INCONSISTENT JESTING LAUGHING
LEWD   OBSTINATE PERFECTIONIST QUARR
ELSOME RESERVED SHY  
SLY TICS VIOLENT VIVACIOUS
WANDERING   WEEPY
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FUNCTIONING (PARTS, ORGANS, SYSTEMS, INDIVIDUAL)
RECREATIONS
APPETITE   ELIMINATIONS   ADDICTIONS TEA
COFFEE PAN   SUPARI TOBACCO   ALCOHOL
BEER DRUGS     WORK AVERSE SATISFACTION  
EXCESSIVE EFFICIENCY     CONCLUSION
BALANCE EFFICIENCY ADEQUANCY ENERGY
STOOLS   URINE   PERSPIRATION   MENSES   DISCHARGE
S
SEX         SLEEP DREAMS
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THOUGHTS IDEAS ANXIETY FORE-BODINGS COMPLAINTS
DREAMS
SLEEP DURATION POSITION CHARACTER LIGHT CATNA
PS DEEP DISTURBED UNREFRESHING POOR SIESTA
CONCOMITANTS ON GOING TO (FALLING INTO)
BEGINNING DURING AFTER CHEWING EMISSIONS
ENURESIS FIGHTING GROANING JERKS
(MYOCLONUS) MOANING PERSPIRATION SALIVATION SCR
EAMS STARTS TALKING TEETH-GRINDING WALKING WEE
PING (SOBBING) MODALITIES ON FALLING
INTO BEGINNING DURING AFTER (WALKING ON)
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DREAMS (Describe)
ACCIDENT BATTLES BUSY DEAD BODIES DISGUSTING EXHAU
STING FALLING FLYING GHOST JOURNEY MONEY NIGHT
MARES POLICE RAPE SNAKES UNPREPARED VEXATIOUS WEEP
ING
AMOROUS (SEX) BIRDS CRIMES DEATH DROWNING EVENTS
REMOTE / RECENT / FUTURE FEASTS FRIENDS HISTORIC M
ANY MURDER PARTIES PROPHETIC RELIGIOUS STOOLS UNRE
MEMBERED VIVID WILD
ABSURD ANXIETY BUSINESS (WORK) DEAD DISEASE EXAMIN
ATION FAILING TASK FIRE FUNERALS INSECTS MISSING
TRAIN MUTILATION PLEASENT QUARRELS SAD UNPLEASANT
URINATING WEDDING
ANIMALS BURIAL DANGER DEVILS EMBARRASMENT FIGHT F
RIGHTFUL HUMILIATION MISFORTUNE BEING
MURDERED PERSISTENT PURSUIT ROBBERS TEETH
BREAKING UNSUCCESSFUL WATER
SEA
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DREAMS ANALYSIS
DESCRIPTION LIFE SITUATION INTERPRETATION

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MENTAL DISPOSITION

• Arrangement for the accomplishment of a Purpose
  Plan
• The State or Quality of Being disposed (to, OR to
  do something)
• The condition of Being

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WHAT IS THE EVOLUTION OF THE MIND?
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??????????????? ???? ????????????????????
??- ???

• In the case of a person who dwells on objects,
• there arises attachment for them.
• From attachment grows hankering, from hankering
  springs anger 2.62

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???????????? ?????? ?????????????????????
????????????????????????? ?????????????????????
??- ???
From anger follows delusion from delusion,
failure of memory from failure of memory, the
loss of understanding from the loss of
understanding, he perishes. 2.63
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(No Transcript)
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Know the Atman as the Lord of the chariot, the
body as the chariot Know the intellect as the
charioteer and the mind again as the reins. The
sense (and the instincts) they say, are the
horses, and their roads are the sense
objects. The wise call Him the enjoyer (when He
is) united with the body, the senses and the
mind. One who is always of unrestrained mind and
devoid of right understanding, his sense-organs
become uncontrollable like the vicious horses of
a charioteer. But of Him who knows, and has a
mind always controlled, the senses are always
controllable as the good horses of the
driver. Kathopanishad III3-6
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THE CONSTITUENTS OF THE MIND
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PRESENTATION
RR/23-10-96/NAVIN

• RR, 30 YEARS DIP ENG (CIVIL), MARATHA, JR
  ENGINEER BSES
• ACUTE EXACERBATION OF CHRONIC COLITIS OF SIX DAYS
  DURATION
• EXACERBATIONS EVERY 6 MONTHS - SINCE 6 YEARS
• SLEEPLESS WITH DREAMS OF BEING PURSUED-EXHAUSTED,
  UNABLE TO RUN AND FALLING UNCONSCIOUS, FALLING
  FROM HEIGHT, DEATH OF RELATIVES - SINCE 8 YEARS
• HYPERACIDITY - SINCE 10 YEARS
• ENDOSCOPY SPASTIC COLON WITH STASIS COLONOPATHY
• HISTOLOGY MILD ACUTE ON CHRONIC COLITIS

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BACKGROUND

• POOR FISHERMAN FAMILY FROM INTERIOR
• CONSERVATIVE, RITUALISTIC- IDOL WORSHIPPERS,
  LIVING FROM DAY-TO-DAY
• ILLITERATE PARENTS
• ALCOHOLIC, NAGGING, VIOLENT FATHER
• 3 YOUNGER BROTHERS-ALL SCHOOL DROP OUTS

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CHILDHOOD

• ELDEST SON-IRRITABLE AND AGGRESSIVE lt
  CONTRADICTION
• AMBITIOUS, STUDIOUS - COMPLETED EDUCATION IN
  HOSTEL
• FASCINATION FOR THE ARMY AND HITLERS
  EXPLOITS-READING, PLANNING STRATEGIES FOR WAR,
  DREAMS OF WAR
• DISCOURAGED BY FATHER AND INSULTED AND HUMILIATED
  BY TEACHER FOR THIS OBSESSION-STILL REMEMBERS IT
  WITH VEXATION

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a
ENGINEERING COLLEGE

• HESITANT, INFERIOR AND COMMUNICATION BLOCK IN
  ENGINEERING COLLEGE DUE TO POOR ENGLISH
• ANXIETY ABOUT STUDIES AND SUCCESS
• SOCIAL DISTANCE DUE TO POOR FINANCES
• INNER FRUSTRATION VENTED OUT ON FAMILY
• RESULT SLEEPLESSNESS, EPIGASTRIC PAIN AND
  HYPERACIDITY

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a
EVOLUTION OF TROUBLE

• DIPLOMA? STATUS AND EMPLOYMENT ? ?STARTED BEING
  TREATED WITH RESPECT AND CONSIDERATION BY THE
  FAMILY
• YET PAST INSULTS AND HURTS TROUBLED THE MIND
• POWER AND STATUS DOMINATED THE OUTLOOK
• PSYCHOLOGICAL DISTANCING FROM FAMILY NORMS AND
  MODES OCCURRED

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EXPRESSIONS

• CRITICAL, QUARRELSOME, CENSORIOUS OF THE WAY OF
  LIFE
• ATTACKED TRADITION, RITUALS AND BLIND WORSHIP
• ATTACKS OF RAGE WITH TOTAL UNAWARENESS OF
  SURROUNDINGS
• DESTROYING PHOTOS OF IDOLS, TRAMPLED ON
  SENTIMENTS, FORCED TO STOP TRADITIONAL PRACTICES
• EXTENDED OPPOSITION TO THE COMMUNITY AND
  RELIGIOUS GATHERING EMBARASSING THE FAMILY
• REJECTED BROTHER WHO HAD FAILED - DID NOT HELP IN
  FINDING A JOB
• RESULT FRIGHTFUL DREAMS

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a
PRECIPITATION OF COLITIS

• CHANGED JOB-POSTED OUT OF THE DISTRICT FOR
  TRAINING - SEPARATION FROM FAMILY
• ONSET OF DRINKING
• HARD WORK - DAY AND NIGHT-TECHNICAL SKILLS
  DISPLAYED-NO INTERPERSONAL RELATIONS DEVELOPED
• GOOD REPUTATION WITH SENIORS, NO NONSENSE
  ATTITUDE WITH SUBORDINATES-HAPPY AND SECURE IN
  JOB
• QUIETENED DOWN? ONSET OF COMPLAINTS
  COLITIS-MUCUS AND BLOOD

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POST-MARRIAGE

• WIFE SIMPLE AND RELIGIOUS-MANAGED TO CONVINCE HIM
  TO ALLOW HER TO CONTINUE WITH SIMPLE WORSHIP
• MAN OF FEW WORDS. WILL PROVIDE ON HIS OWN BUT
  WILL NOT ASK THE NEED
• STRAIGHTFORWARD, IRRITABLE, PROUD PERSON
• LOOKS DOWN ON RELATIVES BUT SUPPORTS IN TIMES OF
  NEED

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PHYSICIANS OBSERVATIONS DURING INTERVIEW

• SITTING STRAIGHT AND UPRIGHT WITH CHIN HELD HIGH
• LOOKED STRAIGHT INTO THE EYES OF THE PHYSICIAN
• MOIST, SHARP EYES - FACE STERN AND COLD
• VOICE-DEEP WITH MEASURED TONE
• SHORT, NEATLY COMBED HAIR, CREASE-FREE SHIRT? AN
  OFFICER WITHOUT UNIFORM

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WHAT DO WE NOW KNOW OF THE PATIENT?

• TRACED THE EVOLUTION OF THE PATIENT AND HIS
  COMPLAINTS
• STUDIED THE EXPRESSIONS AT THE LEVEL OF THE MIND
  AND THE BODY
• RELATED BOTH TO THE CHANGING NATURE OF TIME AND
  CIRCUMSTANCE

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WHAT ARE STAGES OF EVOLUTION OF THE PATIENT AND
HIS ILLNESS?

• DISPOSITION-The childhood
• DIATHESIS The early college years
• FUNCTIONAL ILLNESS The hyperacidity and the
  psychological distress
• STRUCTURAL ILLNESS The colitis

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WHAT ARE THE EXPRESSIONS OF THE MIND?

• THE DESIRES-The army
• THE FEELINGS-The fascination, the humiliation and
  the frustration
• THE IMAGINATION-The fantasies
• THE THOUGHTS-The brooding
• THE BEHAVIOUR The violence
• THE DREAMS- The danger