Back to the Source: How the Power of Objective Observation will Revolutionize Your Homeopathic Practice

(This article was published in the Winter 2012/2013 issue of Simillimum, a journal of the Homeopathic Academy of Naturopathic Physicians and is slated to appear in the American Institute for Homeopathy’s Summer issue of the American Journal of Homeopathic Physicians)

For decades, homeopathy has been undergoing a kind of renaissance, whereby homeopathic academicians attempt to bring clarity and order to the complexity of modern day homeopathy.  In an effort to refine and build upon Hahnemann’s teachings, leaders in homeopathic education are advancing new systems and methods all the time.  Such new understandings are quickly making their way into practitioner training programs as well.

One of the main goals back of this renaissance of new ideas seems to be to provide a grounding and semblance of order to the ever-expanding pool of information daily entering into the homeopathic databases.  Arguably, these innovators and pioneers are attempting to further the scientific basis of homeopathy, with the intent of sharing the benefits resulting from their vision and hard work.  But if you speak with students the world-over, there is widespread concern, as training for years often does not lead to high-level clinical proficiency and consistent results in practice.  Their complaint: they still can’t find the simillimum after many hours and many dollars spent on courses.

It is my contention that superb, high percentage, positive results is indeed quite possible, without the need of devising intricate systems, methodologies, and categorizations of our materia medica.  What is needed for training and eventually mastering homeopathy is not more, but actually less.   Filling our minds with copious amounts of information, diverse and extensive strategies in case observation and analysis, and increasing in-depth study of materia medica is not, and will not, lead us to the so-called Holy Grail of Homeopathy.

A cursory review of student performance in current seminars and training programs reveals some surprising facts. Attend any homeopathic school or seminar where live cases (or video cases for that matter) are presented and you will see not only a curious lack of consensus over which remedy best fits the case, but you will also witness wide disagreement as to potency selection and case management issues.   Even more disconcerting, one will discover often that a high percentage of live cases seen in follow-up will have not responded particularly well to the remedy chosen by the instructor.

Reproducibility of outcomes establishes a discipline on solid scientific footing and serves to enhance its public reputation as being sound and reliable.  On the whole, I am not certain that most of our current methods used in training homeopaths are succeeding in the basic requirement of reproducibility and demonstrable proficiency.

As a vitalistic tradition, however, a purely scientific basis is insufficient when working with cases in homeopathic medicine.   While many of the basic principles and methodologies of homeopathy rest on a solid scientific foundation, a vitalistic medicine, involving living human beings, will forever and invariably remain of discipline requiring the application of both science and art.  For science does not concern itself with immeasurable things, and the human experience will always contain aspects that are inherently immeasurable.

Though the physical, human body is fully accessible to scientific inquiry, description, and measurement, the human soul is not.  Because we human beings are an amalgam of body and spirit, we defy absolute scientific reductionism.  According to homeopathic doctrine, the major cause of human disease is rooted in a disturbance of the spirit, what Hahnemann referred to as the “vital force.”  The fundamental nature of such dynamic disturbances simply defies pure scientific analysis.  The effects can be observed and cognized, but the source itself cannot be measured as far as we know.

To cure disease states dynamically at the level of the source, we must learn to correctly identify those hallmarks of observable signs and symptoms that result from these spiritual disturbances.  To achieve this, one must acquire the skill of objective observation.  For objective observation, more than a keen mind is required.  To be reliable, such observation involves participation of the heart as well.  Essentially, both faculties of perception, the mind with the heart, need to be honed and integrated for mastery in homeopathy. In this context, training competent homeopaths is not so much about teaching them what to see, but rather how to see.  We all have an innate capacity for objective observation.  For many, these faculties of perception are simply under-functioning or underdeveloped.

To my knowledge, most curricula and training programs bring little substantive direction as to how to engage the mind and heart, without which high-level proficiency can be quite elusive to the student.  Homeopathy has and always will be more than a mechanistic science.  As a vitalistic healing discipline, complete mastery of homeopathy necessitates evolving one’s own being alongside of intellectual growth.  Homeopathy is a medicine not only of facts, but of meanings.  Meanings, as such, must be experienced and felt.  The cold, impartial lens of mental observation alone is not enough.

My proposition is this: the alchemy of healing—which involves mind, body, and spirit—is, and always must be, one predicated on both science and art.  To be most effective, objective observation is best informed by a blending of art and science.  Its accomplishment, borne by clinical experience, must involve more than the use of the mind alone.  It also requires a compassionate activation of the feeling side of healing, stemming from the heart.

Unless we learn to develop and harmonize these two central aspects of ourselves, namely our mind and heart, and bring them skillfully to bear on our working with patients, all the external systems, books, computer programs, and new philosophies will fail to deliver at the highest level that we are striving for.  The answers we need are not found somewhere outside of us.  Wisdom, understanding, and true discernment, which result from knowledge and life experience, coupled with a balanced function of mind and heart, reside within.  The trick is learning how to access and apply them appropriately, always with a scientific grounding.

With the burgeoning number of available proven remedies and rapidly growing repertories, it is mind-boggling just how to make this unwieldy complexity accessible to the student and practitioner.   Information overload has long ago become a very real concern.  Classifications and groupings of remedies according to new theoretical frameworks have become the contemporary norm, though no universal agreement has yet been reached.   Whether such schemas will be workable for the newer practitioners and gain universal acceptance remains to be seen.

New methodologies for understanding our cases are also being widely proposed, while students struggle to apply them with the reliability and success they envisioned after observing them in action at courses and seminars.   Didn’t Hahnemann, in his footnote to Aphorism 1 of the Organon, exhort us “not to spin so-called systems from fancies and hypotheses” that do not have scientific validation or verification?  How scientific and valid are these new approaches?  How easily are they taught and integrated into the foundation of the homeopathic art and science.

In theory, many of the currently taught systems sound intellectually plausible and are aesthetically appealing.   Yet, in actuality, they leave many students disappointed when they attempt to apply them on their own.  These teachings arise out of an individual’s creative inspiration and insight, rooted deeply in their own personal homeopathic experience and perspective.   Most often, such concepts only get formulated after decades of clinical work.  Such pioneers create their new vision upon a solid foundation in the classical methods, philosophy, and extensive clinical exposure to patients.  What works for the masters may not come so easily to the student or intermediate practitioner, if it ever comes at all.  Again, without the acquisition of the kind of perception that leads to innovative ideas, their application generally remains very inconsistent.

As an example, I saw a case not long ago where the patient had not seen much change after taking several remedies from her previous homeopath.  This individual had a life-long fascination with dolphins, loved the ocean more than anything else in the world, and demonstrated nurturing/security issues with her mother.  The previous homeopath gave Lac delphinum (dolphin’s milk), purportedly based on the above stated factors, but it had no observable effect whatsoever.  The remedy that worked unarguably in this case was Baryta carbonica (barium carbonate), which precisely matches this patient’s symptom profile, including emotional and intellectual “backwardness, “ demonstrable insecurities, and frequent embarrassment, amongst several of the other observed characteristics.

This example shows how applying theories without having both feet planted solidly on the ground can lead to missteps, and ultimately to the selection of ineffectual remedies.   Our artistic side must necessarily have a voice in our work, but not at the expense of leaving the grounding and stabilizing influence of our science behind.  Again proper training must establish a proper balance between science and art, mind and heart.

In our training, we all want to have been prepared to not only succeed in the majority of cases, but to do so with enjoyment, satisfaction, and, even the thrill of wonderment and awe.  When I interview homeopathic students from far and wide, to ascertain whether the promise of true proficiency in practice is actually being delivered by our programs—which, by the way, is certainly widely accomplished in conventional medical training– it seems that we are missing the mark.

By honestly examining the success rates in the private practices of our homeopathic graduates, it is rare to find that they are achieving a high percentage of long-term cures (meaning at least 80% or higher).  Most practitioners, when carefully evaluated, are finding the curative remedy inconsistently, even after many return visits.  Frustrated by what can feel like very lackluster results, students and practitioners are drawn to study more and study harder.  In the end, this “go harder and longer” strategy yields diminishing returns.

In my opinion, the most basic answer to the students’ dilemma lies in Aphorism 3 of the Organon, where Hahnemann states:

If the physician clearly perceives what has to be cured in disease, i.e., in each individual case of disease (knowledge of the disease ), if he clearly perceives what it is in medicines which heals, i.e., in each individual medicine (knowledge of medicinal powers ), if he applies in accordance with well-defined principles what is curative in medicines to what he has clearly recognized to be pathological in the patient, so that cure follows, i.e., if he knows in each particular case how to apply the remedy most appropriate by its character (selection of the remedy ), prepare it exactly as required and give it in the right amount (the correct dose ), and repeat the dose exactly when required, and, lastly, if in each case he knows the obstacles to cure and how to remove them, so that recovery is permanent, then he knows how to treat thoroughly and efficaciously, and is a true physician.

This “clear perception” Hahnemann writes about, in order to be of highest service, must be derived from a refined amalgam of mind and heart.  In matters of true import, the mind was not meant to function in isolation.  The cold, razor edge of pure intellect needs the warming flames of feeling to temper its observations and bring balance to its renderings of truth.  As human beings we were gifted with both faculties, and when used together, they work best.  And no amount of external methods or getting more tools into our medical black bag will substitute for the rigorous requirement of learning how to develop both aspects of ourselves as we investigate “each individual case of disease.” Otherwise, a good computer would be able to do the job sufficiently on its own, which, of course, we know it cannot.

Bringing the mind and the heart to bear on our ability to objectively observe means we engage more than thought in the process of working with our patients.  With the addition of feeling, we open to a more balanced, spontaneous, and human quality of interacting in the consultation room.  Knowing intimately the depth and breadth of human nature in health and disease, combined with a deeper and broader knowledge and understanding of our selves, arguably renders the homeopath, not ideas and methods, the most potent tool in this healing work.

Think about how the mind, working alone, is often challenged to discern the truth of things.   The mind is so easily swayed.  A good con man is quite capable of mentally convincing his subject about the veracity of his promises, yet inexorably leads his trusting victims to ruin.  Modern-day ponzi schemes are perfect examples of this.  So too, the often complex and intricate stories of our patients can and do easily lead us astray, and divert our attention away from truth and what needs to be cured.

We, as humans, were given the capacity to feel, because feeling provides another dimension to perception that allows for better discrimination of experience.  Without this critical component of feeling, the subtleties and nuances of meaning are easily lost, rendering our perceptions, conclusions, and decisions less consistent and reliable. By incorporating feeling into our work with patients, it balances our keen observing mind. We avoid unwittingly falling prey to persuasive ideas, without realizing the flaws or dangers that lurk behind them.

I remember a case I once saw, who was referred to me by a local chocolatier.   This woman came to my office dressed in “chocolate” colored clothing, a tee-shirt with words and logos about chocolate, a history of a deep love and fetish for all things chocolate, and was soon to be traveling to attend an international chocolate festival.  All of this was easily observed in the first few minutes of meeting her.   Just by the “taste” and feel of her, I knew the remedy immediately: of course, it just had to be homeopathic Chocolate!

Nevertheless, I still took the trouble to dispel my initial intuitive conclusions and took a proper case.  I wanted the mind to verify what the heart seemed to know already.  All of the symptoms that came out—ranging from her depression, aversion and prickliness with children, her somewhat intolerant and irritable nature, menstrual symptoms, and craving for chocolate, all confirmed her remedy.  And, of course, it worked.

Applying objective observation and using the classical tools to identify the remedy were more than adequate for finding a deep acting remedy for this patient.  Even though in cases like this, the source substance seemed to be telegraphed loud and clear, no matter which way one investigated this case, it seems somehow reassuring to know that the solid foundation of homeopathy’s “tried and true” methods are trustworthy.

With our patient’s future health and well-being at stake, I feel we owe them to work with a consistent balance between science and art, so that we don’t go off on a limb, floating in the clouds of imagination, where sometimes, as described earlier, we choose remedies that sound good and clever but offer little benefit.  Our education must incorporate training for the heart, if it is to serve us best.

Because we must address mind and heart in our training in homeopathy, teaching cannot be entirely linear.  As a multi-dimensional, energetic (dare I say, spiritual) healing modality, it has as much to do with resonance, as ideas per se.  The Law of Similars, which solidly and incontrovertibly underlies the healing process, is a direct expression of the concept of resonance.  In order to heal at all, there needs to be a resonant relationship between the disease and the restorative intervention.  This is what is meant by the idea of simillimum: that remedy that is most similar in resonance to the disease to be healed.  In addition, the discovery of the most appropriate and deeply acting remedy can only arise out of a resonant relationship that the practitioner establishes with his or her patient/client.

What this means is that the practitioner must learn to engage her mind and heart in such a manner as to achieve resonance with the case at hand.  When this occurs, the clarity of perception is at its most subtle and precise.  What needs to be cured, the identification of remedy, and the initiation of healing all combine into one complete experience.  Arriving, entering, and recognizing the core of a case is a hard to describe experience, yet it is as palpable as it is unmistakable.  It results exclusively from this integration between mind and heart, as the homeopath attentively, interestedly, compassionately connects with his patient. Instead of external, intellectual reference points in which to pigeon-hole our cases, we learn to rely upon the internal experience of clear understanding of the case at hand, without reference to any other case or external idea.

To witness, to see and be seen, is a human faculty of spirit and cannot be reproduced by any formula or mechanical device, even the most sophisticated computer.  Because homeopathy is a vitalistic medicine, its ultimate meanings are uncovered through the experience of things, not so much from the thinking about them.

Some have argued that training students in the skills of observing objectively is one of the most challenging parts of homeopathic training.  How exactly does one teach another to develop and hone such skills? Isn’t there a certain amount of personal inner work, life experience, and maturation required before one can attain the requisite skill sets?

I agree that this kind of knowledge is not so easily communicated and readily transferable.  Nor is it something that occurs all at once.  Homeopathic education is necessarily holistic and is not amenable to book learning alone.  To become truly proficient requires spending time with teachers who have mastered these skills and also who embody the qualities we are seeking.

At this point, the reader may wonder just how a homeopathic training program can teach its students the more qualitative skills of engaging the heart, and combining the artistic side of practice as an important complement to all the very quantitative, scientific aspects of homeopathic practice.  For in essence, objective observation is not something removed from the core of who we are, like a movie camera viewing the world from somewhere outside of us, but it actually encompasses the fullness of our being, a complete blending of mind, body, heart, and spirit.

In all traditional healing systems, which, like homeopathy, are based on a vitalistic model, there is a component of training that involves close intimate work with the teacher, which always goes beyond the didactic.  Known as the “oral tradition,” the student learns and develops the deeper qualities of their craft through an apprenticeship type of relationship.   This is a time-tested method for effectively transferring to the student the kinds of knowledge and wisdom that underlay the art of practice.  It serves to wake the student to their hidden capacities and strives to help advance one’s emotional and moral character, so that objective observation or “clear perception” is more readily accessible.

Through direct contact with a master teacher, students learn by example, not just what to do, but how.  The master teacher serves as a kind of energetic compass, pointing the student to her own inner true north.  In a real apprenticeship relationship, when a group works closely with a teacher, there is a kind of collective group energy that starts to activate.  Students begin to directly experience what a resonant connection with cases feels like, and begin to recognize the feeling state of what they are looking for.  Learning in this direct and experiential way allows us to resonate differently with our patients and the life around us, generally leading to a new level of experience that is both energizing and invigorating.

Unlike purely didactic curriculums, even those that show live cases and discuss them, working with the apprenticeship model directly engages our full selves, allowing exposure of our weaknesses and shortcomings, thus helping us to know ourselves better.  This is accomplished primary by direct feedback and gentle guidance by the teacher as issues of perception or understanding arise.

A willingness to be vulnerable in the learning process and see what needs to be improved in ourselves is very powerful way of increasing self-awareness and enhancing the clarity and quality of our perceptions.  Talking about it is not enough.  Studying more ideas is not enough.  There has to be some kind of molding and shaping phenomena which is intrinsic to the apprenticeship experience.  Sometimes we simply need someone who sees more than we do to point out our blind spots and where we are stuck.

For many, the risk of being vulnerable—a necessary part of real personal growth and change—can be a stumbling block.  It is reasonable to make our selves vulnerable, as long as one knows that one is safe and respected.  The payoff of being vulnerable comes in the form of personal advancement and proficiency as a homeopath. This payoff can be measured in so far as students more consistently replicate the process and successfully understand the cases, finding remedies that work.  Ultimately, the consistency and proficiency of their finding deeply curative remedies must be the final arbiter of how well students are progressing in their training.

By teaching students through apprenticeship how to be sound, objective observers, they gradually learn to catch the nuances and subtleties that present during case observation, and to identify much more readily that which is most characteristic to each case in question.  Knowing that just such characteristics must be matched or covered by the remedy selected—because in being the most similar it must share them—clarifies the act of seeking the simillimum through the repertorization process.  One learns to carefully choose symptoms in the repertory only after establishing a clear and definitive understanding of the case.

The trap that so often befalls the unwary student is to reference characteristics from external systems that he or she has already learned because they appear to match what one “thinks” or “believes” is taking place in the case being observed.  This looking to the outside for answers, before a resonant connection is made with the case at hand leads one away from acquiring the vital knowledge requisite for a true understanding of the case.

In such a fashion, cases are blatantly or sometimes very subtly forced into known schemas, effectively matching the case to a remedy, category, or concept, rather than the other way around, matching a remedy to the case.  Needless to say, this tendency frequently leads predictably to unreliable results.  We find comfort in grasping for what is already known, even if it doesn’t serve us in the end.

With practice and perseverance, under direct tutelage and supervision by a practitioner who has mastered this way of working, most cases will readily open up and reveal themselves to the “objective observer.”  Through a deep understanding of the case, arising from a finely tuned awareness of mind and heart, the remedy that matches will almost always “light up,” after careful repertorization.  The reason is that the remedy chosen in this way will invariably resonate with the understanding and clarity that arose from objective observation in the case-taking process.  Indeed, there is an inherent simplicity in this process, once clear perception is achieved.

By getting a real taste and feel for proficient work in homeopathy, most students can make further advances on their own, through diligent practice and, of course, perseverance.  To the extent that each one develops and hones oneself in this way, the capacity and competence to understand cases will grow accordingly.  And so will one’s confidence and satisfaction. Students report that they start to notice things that they didn’t used to notice.  Though they will not fully ripen in the period of their training, a potent seed is planted and has already sprouted, ensuring future growth along these lines, provided the student values and continues to nurture it.

My experience in my own training program, “Homeopathy Through Simplicity: The Objective Observer Course,” has shown that the approach I describe is reliable, reproducible, and accessible to students, new and old.  In the evaluation of live cases in class, there is a high level of unanimity in characteristic symptom recognition, rubric selection, and remedy choice.  The highly positive results in the vast majority of cases seen in class after the remedy is taken is a testimony to the efficacy and utility of this method of learning.  It also demonstrates that is it possible to train students in what they truly need to know, not just in the mind, but also in the heart, in order to attain proficiency as practicing homeopaths.

These reproducible and satisfying results can be achieved without emphasizing the impossible task of mastering vast segments of our ever-expanding materia medica or all the new systems of philosophy and method being taught world-wide.   There is, in fact, minimal emphasis on extensive memorization and rote learning.  It only take is a willingness to establish a solid foundation in the basics of Hahnemann’s teachings and to gradually refine and perfect one’s own self as an instrument for the high art and science of objective observation.  This is not theoretical work, but one achieved on the ground, in the practical clinical setting of working with live cases.

Learning to be objective observers, which requires both mind and heart, is the most vital, powerful, and effective tool a student of homeopathy can develop and acquire.  It also carries the potential to bring the deepest satisfaction and sense of connection with our patients and our work.  Many methods and systems of thought teach us means to heal symptoms at various levels of illness.  However, if we wish to attain Hahnemann’s highest ideal of cure, as described in Aphorism 9, so that:

“The reasoning spirit who inhabits the organism can thus freely use this healthy living instrument to reach the lofty goal of human existence,”

then we must endeavor and work conscientiously and tirelessly toward a refinement of self. Through the gradual perfection of the perceptive functions of mind and heart, the true faculty of objective observation emerges and becomes fully operational.

While there is no shortcut to mastery in any field or discipline, this path of learning to be an objective observer is certainly one that will help the motivated student arrive at eventual mastery, directly, inexorably, and with assurance.  In my experience, you, the homeopath, are the most important tool in the toolbox, trumping all others by leaps and bounds.

Douglas Falkner, MD, MHom is the founder of The Falkner School for Homeopathy and the chief instructor for its practitioner training program, “Homeopathy Through Simplicity: The Objective Observer Course.”  Formerly working as a hospital-based Emergency Medicine attending physician, Dr. Falkner combines his extensive conventional medical knowledge with his deeply rooted understanding of the homeopathic healing art.  He maintains a busy clinical practice in homeopathy in Ashland, Oregon, and offers phone consultations nationally and internationally.   He is currently enrolling students in his next three year practitioner training program.