Translate this page into:
Conflicts of adolescents and their homoeopathic management: A case series
*Corresponding author: Nikita Sureshchandra Mehta, MD (Hom), (Pediatrics), Plot no. 173/B, Street no. 7, R.T.O Re-location site, Bhuj, Kutch - 370 001, Gujarat, India.dr_nikita_mehta@yahoo.com
-
Received: ,
Accepted: ,
How to cite this article: Mehta NS. Conflicts of adolescents and their homoeopathic management: A case series. J Intgr Stand Homoeopathy 2020;3(3):64-9.
Abstract
Objectives:
(1) The objectives of the study were to identify the various conflicts faced by adolescents and resolve them with multidimensional management strategies designed specifically for each case and (2) to explore the role of homoeopathy along with ancillary measures in conflict resolution for adolescents.
Materials and Methods:
The details of the chief complaints, developmental characteristics and the problems faced by the adolescents were studied and analysed. The specific conflicts were identified and individual multidimensional management strategies were devised accordingly. Homoeopathic management along with ancillary measures such as psychological counselling of patient and family, diet and lifestyle modification guidance, meditation and relaxation techniques and career guidance was the basic modalities used to resolve conflicts.
Results:
Positive outcomes were achieved with suitable interventions made at the right time; this not only resolved the conflicts but also helped in preventing any adverse consequences or faulty development of the adolescents.
Conclusion:
This study helps in appreciating the role of homoeopathy in the management of various physical, emotional, intellectual, psychosocial, sexual and behavioural conflicts faced by adolescents. The holistic approach used in the homoeopathic system of medicine along with ancillary measures can cause transformations at several levels, enabling individuals to lead a healthier and happier life as adolescents and adults.
Keywords
Adolescents
Conflicts
Homoeopathy
Ancillary measures
Multidimensional management
INTRODUCTION
Adolescents are defined by the World Health Organisation as people between the ages of 10 and 19 years. Adolescence is the second most rapid and formative phase of life; it is a transformation characterised by discernible physical, cognitive, social, emotional and sexual development. This leads to various changes at the level of mind and body that can produce significant stress and conflicts.[1]
Conflict can be understood as mental struggle resulting from incompatible or opposing needs, drives, wishes or external and internal demands. The conflict can be inner (with self), external (with others) or with the environment as a whole.[2] Conflicts may develop at the physical, psychological, intellectual, social or sexual levels. Differences with parents, hormonal changes and mood disruptions, emotional immaturity, peer pressures and risk-taking behaviours, decreased level of self-control and increased level of sensitivity are some of the factors that lead to the conflicts.[3]
Homoeopathy can play a fundamental role in resolving such conflicts. The role/s of a homoeopathic physician and the knowledge and skills they use are very important. An empathetic approach and strong rapport building during homoeopathic case receiving encourages adolescents to confide and share their conflicts without any hesitations. The therapeutic case taking initiates the healing process Constitutional homoeopathic treatment acts on an individual’s inherent nature and temperament, moulding and harmonising the person’s self-energy to take control of the life situations. Homoeopathy helps adolescents deal with negative behaviours and emotions, improves perception, improves adaptation and healthy coping mechanisms and improves adjustment with the family and society by improving interpersonal relationships. It facilitates building motivation and taking responsibility for one’s own life; it, therefore, improves the personal and professional growth required for healthy adult life.[4]
Homoeopathy, along with ancillary measures, helps address medical, psychological, social and intellectual problems arising from these conflicts. Therefore, it is important to study the role and scope of homoeopathy and various ancillary measures in managing conflicts; it is also necessary to study and analyse the outcomes obtained with individualised multidimensional management.
MATERIALS AND METHODS
Study design: Retrospective Case series study
Setting: Three cases from private practice of the author.
Patient’s consent not required as identity not compromised.
Patient’s guardian’s consent taken where-ever relevant and required.
Participants
Inclusion criteria
All three phases: Early/middle/late adolescence
Both the sexes
Rural and urban areas of Gujarat, India.
Exclusion criteria
Cases from orphanages and childhood trauma rehabilitation centres.
Short summary of the cases
Case report 1
Date: 5 January 2016
Age/sex: 16 years/female
Socioeconomic status: Lower class Education: SSC fail
Father: 40 years, switching jobs; mother: 35 years, house maid; Siblings: 3 younger sisters, 1 younger brother
Address: X village, Gujarat.
The patient complained of frequent throbbing headaches that started with an aura followed by vomiting for the past 5 months; the headaches are triggered by anger and sensory inputs. She was thin and complained of small size of breasts and poor self-image. There was a history of a single suicidal attempt 6 months prior with low mood. At present, her mood was normal, but she had lost her aspirations in life.
Pubertal history and examination: Thelarche: 12 years, pubarche: 14 years, menarche: 14 years
O/E: Tanner’s SMR: Ph5, B5
Interpretation: No signs of poor breast development.[5]
Other G/E: Weight: 42 kg, height: 162 cm, body mass index (BMI): 16 kg/m2 (2nd percentile)
Rest: Nothing abnormal detected (NAD), S/E: NAD.
Diagnosis
Migraine with aura (ICD-10 G 43 1)
Body dysmorphic disorder (ICD-10 F 45 22)
Underweight (ICD-10 R63 6)
Life space
The patient’s father is a chronic alcoholic and does not have a fixed income. The mother is the breadwinner and is always overworked and indifferent. She accompanied her mother for work after dropping out from school. Despite the adversities in her life, she aspired to improve her lot.
In July 2016, she received a marriage proposal, but was rejected by the prospective groom for her poor looks. Repressed anger 3 and disappointment led to a suicide attempt. Her jealousy toward her sisters, lack of friends and feeling of being ugly and incapable of attracting the opposite sex caused serious body image perception issues.
In September 2016, she received another proposal, which triggered the onset of migraine and loss of aspirations.
Analysis of the case
The strained mother-father relationship and poor socioeconomic condition were the major contributing factors for the patient’s poor physical and psychosocial development. As the patient started adolescence, peer pressure influenced her self-perception. Disappointment caused by the first rejection led to the major physical and psychological conflicts of poor self-identity, loss of aspirations and poor social relationships. Despite having normal sexual maturation and breast development, her self-perceived flaws in her appearance indicated a likely mental health disorder. Resurfacing of the old hurts after the second proposal likely resulted in the patient turning the repressed anger on herself, causing the migraine.
Assessment of susceptibility and posology
Susceptibility: High
Functional changes ++
Characteristics ++
Sensitivity: High
Posology: High, 200 to 1 M.
Management strategy used
Homoeopathic management: Nat mur 200 in infrequent doses, Thuja 200 in infrequent doses (as intercurrent remedy)
Role of the homoeopathic physician: A friend, philosopher and guide.
Ancillary measures.
Diet: High calorie and protein diet
Psychological counselling: Cognitive reconstruction, behavioural activation, assertiveness and problem-solving techniques.
Evaluation of result
Complete conflict resolution was achieved after continuous interaction and counselling of the patient for 2 years. Her body image perception improved. Her headaches ameliorated completely. She gained weight and her BMI improved to normal. Her relationships improved. She completed her SSC examination, followed by a 6-month course of general duty assistant and became a nurse, thus fulfilling her aspirations.
Case report 2
Date: 3 June 2014
Age/Sex: 14 years/female
Socioeconomic status: Middle class Hindu family
Education: Pursuing private SSC
Father: Died in 2009, Stepfather: 45 years, Mother: 48 years, service, older brother: 20 years, service
Address: X city, Gujarat.
Patient complained of secondary amenorrhea for 6 months with behavioural changes, recent weight gain and puffiness of face. She also had headaches and acne since a few months.
Menstrual history: Menarche: 11 years, cycle: 5 days/28– 34 days, profuse, pain in legs 2 Regular cycles till 13 years of age, LMP: 6 months prior, <3 before menses, >3 after menses
O/E: General: Mild facial oedema, no other positive findings, BMI: 23 8 Kg/m2, BP: N, acne on face, systemic: NAD.
Investigations: Urine pregnancy test: Negative, thyroid function test: Normal, USG pelvis: No evidence of polycystic ovarian syndrome. Further investigations advised but not done: FSH, LH, estradiol, prolactin, cortisol and GTT.[6]
Probable clinical diagnosis: Amenorrhea, unspecified (ICD-10 N91 2), hypothalamic dysfunction and not elsewhere classified (ICD-10 E23 3).
Life space
Childhood: The patient’s father was a businessman and mother a housewife. Her father had adored her a lot; she was the apple of his eye. She had no difficulties in her life until her father died. After a lot of insistence from family and community, her mother married her father’s business partner in 2011.
Initially, her stepfather used to fulfil all her demands. Soon, she accepted him as her father and started loving him. She was very fond of him, more than of her mother who was strict and did not support the freedom afforded to the patient. Unfortunately, the stepfather took advantage of her credulity (impressionability) and started sexually abusing her when she was just 13 years old. She was completely shattered when she realised what had happened and felt anger 3 toward him. Her mother, instead of empathising, blamed her for the incident. She was made to undergo a ‘purification’ process at their religious place. This was followed by secondary amenorrhea and other physical complaints in January 2014.
Analysis of the case
In this case, losing father at a tender age and then finding that void being filled by the stepfather helped in understanding the evolution of an immature child in her environment. On entering adolescence, she experienced sexual abuse, which was the major conflict in her life. The effects of a traumatic experience on the psyche and soma and the resulting clinical picture were evaluated. Instead of getting personal and professional support, she was estranged and humiliated by her family. This led to more conflicts, namely the strained mother-daughter relationship and psychological-hormonal issues that were a direct result of the indignation3 she felt regarding her situation.
Totality of symptoms and final selection of remedy
Ailments from sexual abuse+++
Ailments from indignation+++
Menses suppressed due to anger+++
Head pain from anger
On repertorisation: Staphysagria and colocynth came up; however, colocynth does not cover the rubric A/F sexual abuse
Final remedy: Staphysagria [7]
Management strategy
A stage-wise approach was planned.
Stage 1
Homoeopathic management: Staphysagria 1 M single dose (high sensitivity and functional changes)
Ancillary measures: Psychological counselling to address her negative thoughts and convert them to positive, anger management, breathing and relaxation techniques.
Follow-up: After a week, menses appeared and lasted for 10 days. The next cycle was regular, but her premenstrual symptoms were distressing. This indicated that her constitutional symptoms were coming forth.
Stage 2
Second prescription and family therapy
Assessment of susceptibility and posology
Susceptibility: High
Sensitivity: Mind ++, Nerves ++
Posology: High potency, 200 to 1 M.
Management
Homoeopathic management: Calc carb 200 infrequent doses, Thuja 200 infrequent doses (as intercurrent remedy)
Ancillary measures: Psychological counselling: Family therapy with mother and child as a unit
Role of homoeopathic physician: Family physician and therapist.
Evaluation of result
Stage 1: The major conflict was completely resolved.
Stage 2: The mother-daughter relationship improved The hormonal imbalance was completely resolved She also managed to pass her SSC and started pursuing vocational courses.
This approach helped in resolving her conflicts and restoring the health.
Case report 3
Date: 6 April 2012
Age/sex: 18 years/male
Socioeconomic status: Affluent Brahmin family
Education: Failed in HSC Science
Father: 52 years, CA, private consulting firm, mother: 51 years, school principal, older brother: 26 years, CA, sister-inlaw: 26 years, CA, both working with father
Address: X city, Gujarat
The patient was referred by his father for his habit of excessive cigarette smoking (20 cigarettes/day) which started after he failed in his XII standard examination. Since the last few months, he was also having problems of binge eating and weight fluctuations.
O/E: Weight 90 kg, height 180 cm, BMI 27 78 kg/m2 (overweight).
Diagnosis
Nicotine dependence, cigarettes, uncomplicated (ICD-10 F17 210)
Overweight (ICD-10 E66 3).
Life space
The patient’s father has always been dominating and authoritative. The mother is strict but caring. When the patient expressed his wish to pursue engineering and not accountancy, it was immediately rejected by the father, after which the smoking habit began. In June 2011, he failed his HSC science examination. Excessive smoking and binge eating began after this.
Analysis of case
The impact of domination by the family on the developing ego and personality of the patient resulted in conflicts. The clashes with the family churned up negative emotions that were further compounded when he failed his examinations. The disappointment+++ and anxiety about his image were expressed in the form of identity confusion and substance abuse.
Assessment of susceptibility and posology
Tissue susceptibility: High
Sensitivity: Mind ++
Characteristics ++
Functional changes ++
Posology: High, 200 to 1 M.
Management strategy
Homoeopathic management: Lycopodium[8] 200 infrequent doses, Thuja 200 infrequent doses (as intercurrent remedy)
Role of homoeopathic physician: Counsellor, philosopher and de-addiction therapist
Ancillary measures
Psychological counselling: Impulse control techniques, motivational interview: Importance of ‘Dvija’ (leading a virtuous life, based on morals and values) for a Brahmin.
Diet and weight management
Mediation
Evaluation of result
Over a period of 10 months, homoeopathic management and ancillary measures empowered him to understand the purpose of life and inspired him to quit smoking completely. His weight became normal and binge eating was completely relieved He started a diploma course in computer engineering. A healthy transit into adulthood without any unresolved conflicts fogging his vision was thus ensured.
RESULTS
Conflicts faced by adolescent patients were successfully resolved with the suitable management strategies.
Homoeopathy along with ancillary measures helped in prevention of any adverse complications or faulty development in the adolescent patients
DISCUSSION
Adolescent conflicts can be identified through a careful and thorough understanding of their evolution through childhood and into adolescence. In this study, the major conflicts that can be identified are physical (nutritional: Undernutrition – Case 1, overnutrition – Case 2 and Case 3), psychological (identity confusion: Case 1 and Case 3, substance abuse: Case 3), intellectual (career choice: Case 1 and Case 3, curtailed academics: Case 2), social (interpersonal relationships with parents and peers: Cases 1, 2, 3) and sexual (perception: Case 1, abuse: Case 2). These conflicts give rise to mental and physical disorders. The individualised management strategies can be planned based on specific needs. The strategies include homoeopathic intervention and ancillary measures such as psychological counselling, diet and lifestyle modification and career guidance. These cases demonstrate that homoeopathy can be very effective in enabling conflict resolution for adolescents Homoeopathy can produce positive outcomes in disorders of the psychoneuroendocrinal axis (Case 2) as well as mental and behavioural disorders (Case 1 and Case 3) in adolescents. Homoeopathy, along with other ancillary measures, changes the faulty perception of an individual and improves adaptation. Individualised multidimensional management thus restores the harmonious functioning of the internal system and transforms the individuals’ conduct of their lives.
CONCLUSION
The case studies highlight the importance of knowledge of
Normal growth and development in identifying the conflicts and arriving at the correct diagnosis
Common characteristics of adolescents in identifying PQRS symptoms for selection of simillimum.
The case studies demonstrate the role/s of a homoeopathic physician and the scope of homoeopathy in various conflicts of adolescents
Homoeopathy, as a holistic healing system of medicine, when applied with other ancillary measures, can bring bout positive transformations in individuals’ lives, as is evident from all the cases in this study
Further studies are required involving larger numbers of individuals from specific ages/sexes or certain geographical/ sociocultural backgrounds with specific aspects of adolescent conflicts. These populations can then be assessed for the finer understanding of homoeopathic philosophy and Materia Medica in homoeopathic management.
Declaration of patient consent
Patient’s consent not required as patients identity is not disclosed or compromised.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- Parent-adolescent conflict across adolescence: Trajectories of informant discrepancies and associations with personality types. J Youth Adolesc. 2020;49:119-35.
- [CrossRef] [PubMed] [Google Scholar]
- Parent-adolescent conflicts, conflict resolution types, and adolescent adjustment. J Appl Dev Psychol. 2009;30:195-204.
- [CrossRef] [Google Scholar]
- Drugs De-Addictions: The Role of Homoeopathy in the Treatment of Pharmaceutical Drugs De-Addiction. In: Health, Wellness and Society International Conference. 2011. p. :20-2.
- [Google Scholar]
- Materia Medica of Homoeopathic Medicines. (2nd ed). New Delhi: B Jain Publishers Private Ltd; 1999.
- [Google Scholar]
- Lectures on Homoeopathic Materia Medica. New Delhi: B Jain Publishers Private Ltd; 2009.
- [Google Scholar]
