A client, Mrs AM, 33 years old, married since 5 years, from Quetta (Pakistan) contacted on facebook on June 27, 2017 for consultation regarding multiple severe and chronic fears and phobias that were seriously impairing her quality of life, physical, mental and emotional health. She was extremely worried, anxious and hopeless regarding her condition. The barrier in case taking was that her circumstances didn’t allow telephonic conversation and all history was initially provided through Whatsapp chat. Despite these issues, thorough case taking was done and all the symptoms from physical, mental and emotional sphere were taken into account carefully and vigilantly.
Following complaints were summarized by the client on various occasions:
The overall clinical picture was significantly predominated by multiple ongoing and chronic emotional problems.The most striking feature was a long and grim list of various fears and phobias which were making her functioning critically compromised.
FEAR and PHOBIAS
Fear of death (Necrophobia)
During case taking she narrated that her uncle died 4 years back and she witnessed his post death rituals and funeral rites. All the ceremonial acts and customs employed at the time of death and burial left a huge lasting impact on her and after that she could never really shake off the thought of death and funeral. She entered a vicious cycle of never ending thoughts about dead bodies, death events, graveyard and after death experiences etc. Somehow she managed to go on with this paralyzing fear until few months back death of her cousin again aggravated her sickening fears. She witnessed the funerary customs one more time (including all the services for dead, bathing, enshrouding of deceased, final disposition of body). All these customs pertaining to death made one thought cling to her mind that “same will happen to me one day” and after that she became so much absorbed in this that she started imagining these scenarios all day long. She was trapped inside her own head with these terrible thoughts of death and after death experiences. “Funeral service” / GHUSUL / JANAZA became the most frightening word for her and she was unable to stay normal after reading or listening it. Her heartbeat used to increase and was unable to maintain her composure after listening / reading / watching anything remotely related to death.
Fear of cemetery / graves (COIMETROPHOBIA)
She was suffering from extreme crippling phobia of graves, dead bodies and funerals. She was unable to pass by any heap of soil or any excavation in ground because it reminded her of graves. Her life was a total misery and her free mobility was restricted due to this phobia.
Phobia of pregnancy / childbirth / labour (TOKOPHOBIA)
After years and years of married life she was unable to cherish joys of her marital relationship and was unable to conceive owing to her extreme phobia of pregnancy and childbirth. This was affecting her marital life as well as social life but she was unable to conceive a child due to her phobia.
Fear of announcements from mosques
This was also difficult for her and she used to anticipate and dread any announcement from mosque (as she relates these with death / funerals / Janaza).
Irrational fears that something bad and catastrophic will happen in near future, fear of unknown.
Phobia of blood
Collapsed at the sight of blood.
Fear of insanity and being mocked for this
She had repeated thoughts all the time that if she didn’t get herself treated she will go insane. This fear kept on bottling up until it actually started haunting her that she will go crazy in near future
Fear of having serious diseases like cancer.
Owing to her disturbing fears she developed a phobia that if she slept she would have nightmares consisting of death, funerals and graves. She developed sleep phobia and her mind did’nt allow her to sleep to avoid bothersome dreams. She had complete loss of peace of mind.
Miscellaneous fears: thunderstorm, ambulance hooters, lizards, dogs, darkness
- Repetition of thoughts and inability to silence the thoughts
- She stated that once the disturbing thoughts started in her mind, she was unable to get rid of them no matter whatever she tried.
Difficulty controlling mental images
She had totally lost control on her mind and her mind forced her to imagine and picturize funeral and death scenes
Thinks herself psychiatric patient
She was convinced that she is psychiatric patient but she didnt want to consult a psychiatrist because she was afraid of being socially stigmatised as “nafsiyaati mareez” (in her exact words). She was also disturbed with the thought that people will call her insane / crazy / Psyco Patients if she sought any kind of help.
She had a feeling that men look at her strangely and she also thought that somebody is chasing her or is behind her.
She also had various physical complaints
- She had a very prominent complaint of sleep disturbance, nightmares (content mainly consisting of dead bodies, funeral, graves). She had extreme difficulty lying down in her bed due to anticipation of nightmares. Once her sleep was interrupted, she was unable to go back to sleep.
- Decreased appetite and thirst (anorexia)
- Since her mind used to be so absorbed with thoughts that she lost her normal appetite and thirst.
- Burning while urinating
- Hair fall
- Frequent episodes of flu
- Leucorrhea and painful menstruation (on and off)
- Restlessness and extreme anxiety all the time
HABITS / DESIRES / AVERSIONS
Aversion / Doesn’t like: Salt, milk, yogurt, eggs, strawberries, peas, turnip
Desire for / Inclination for: ice cream, chocolates, cold drinks, Pepsi
Sleep Position: Sleeps on her left
Perspiration: Perspiration on neck and back only when there is too hot
- Heart attack: Uncle died at 40
- Intestinal cancer: First degree relative
- Paranoia / Anxiety: Brother
Factors impairing quality of life significantly
- Cannot use TV, Social media (Facebook) due to fear of coming across any news of disaster, bomb blast, deaths or any image showing death, blood, graves or funerals
- Cannot enjoy life in general owing to horrible thoughts, crippling phobias and anxiety
- Sadness, hopelessness due to constant thoughts of fear of future and death
- Physical relations with husband are highly disturbing due to Phobia and fear of pregnancy and childbirth.
Case Analysis and Homeopathic Treatment
Aconitum Napellus was prescribed on July 05, 2017
By Reprotizing the case, we find Phosphorus and Arsenic Album main remedies on top. But to me It is a clear case of Aconitum Napellus, as fear of death is the most prominent factor. My clinical experience, modern and classical literature supports this decision. The detail is as follows.
George Vithoulas has very beautifully explained the fears and phobias of Aconite in his Materia Medica Viva.
The shocks in an Aconitum case penetrate the entire body and mind and send the whole organism into a shudder, into extreme trembling with tremendous restlessness, unrelieved by any change of position, and an agonizing fear of death. Phobias, especially of death, that persist for years can result. It produces a fear that death will come on suddenly, when least expected; this phobic state is not constant, but rather one that comes in fits. The fear is most accurately expressed as a “fear of impending death.”
We witness this kind of picture today in patients suffering from phobic neuroses. From time to time, with or without small provocations, acute states erupt with the above characteristics.
The attacks are not regular, nor are they constant; they come in fits, in sudden acute crises and can come at any time and as a consequence of any stimulus. The most important point is that in almost all cases we see a tremendous fear of death, which sometimes reaches panic proportions, in addition to the feeling that death is imminent. A physician attending an Aconitum patient in a crisis may hear the patient saying that he has “come too late,” that he will “die soon”, this being another expression of the presentiment of death. The books say, “Predicts the time of death.”, and while it is not always expressed in exactly these words, the patient’s comments will have the same implication. A similar fear of death during pregnancy or during labor can be seen and is a keynote for this remedy. In chronic conditions the patient will not make such specific predictions; he just has a general presentiment that death will come soon and suddenly. For instance, a woman may fear that she will die before she can bring up her children. This is an almost clairvoyant perception; in fact this remedy often has clairvoyant experiences and in particular clairvoyant dreams.
Dr Kanodia quoted Dr. A. H. Grimmer in his famous book Life Saving Drugs in Homeopathy; Dr Kanodia K. D. – B. Jain Publishers India. (2005) that a dose of Aconite given to nervous soldiers who are full of fear of death or other horrors and anxieties would soon help then to face their ordeals with strength and resolution.
Dr Kent is the top most respected pioneer homeopaths and his Lectures on Materia Medica is considered highly reliable literature. He says
Sometimes a pregnant woman will say, “Doctor, there is no use your planning for my confinement. I know I am going to die in that confinement.” If there is any one think that is a really strong symptom to prescribe on it is that A dose of Aconite, and then change the subject. She goes away, and in a few days you her about that fear and she says, “Oh never mind that.” ………