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Medical Boundaries: Which Are Necessary?


Did you hear the one about the doctor who went fishing with his patient?

Neither had I until a friend told us about a trip he’d taken with his doctor to go fly fishing.

I wondered if he always went fishing with his doctor and he said, “No, if I have to take off my pants we meet at his office.”

This set me to thinking, as usual. In my training as a social worker, boundaries were—if you can imagine this—simultaneously rigid and blurry. They were rigid when it came to three basic things:

  1. Whatever is done must be done for the benefit of the patient. Period.
  2. No sexual relations whatsoever—implied, verbal, or physical—with any patient even when that patient has been terminated from treatment.
  3. No manipulation of the patient for personal gain, e.g., getting particularly close so you can meet his Hollywood producer cousin.

After that, however, the rules are fuzzier. In social work, the office is not the only place treatment takes place—it happens in the home, on the street, in homeless shelters, domestic violence advocacy centers, in schools, and just about anywhere else people get hurt or feel unhappy or need help. It is one of the few schools of psychotherapy that accounts for the person in situ—that we are more than a conglomerate of neural impulses or internal motivations. We live, breath, and move in an environment. We are driven not only by our own minds but by the currents that surround us. Interventions, then, must not only take those forces/currents into account, but deal with them. Sometimes that means that we move the office outside into the patient’s life.

But what about being—rather, more specifically, would I become friends with a patient? Or, conversely, would you be friends with your doctor?

Personally, there’s something about the idea that makes me nostalgic. There was a time, not that long ago, that a doctor was not a deity surrounded by the impermeable membrane of incomprehensible technology. A doctor was just another member of the community. He raised children that went to school with our children. He went to religious services with (or near) us. He got sick, took walks, bought food, and went fishing just like everyone else. We knew his first name. He knew all of ours.

Healing was not some private province. It was part of the large, bumpy wheel of living and dying.

If I’ve told you all this story before, forgive me, but it’s one of my favorites. My father is a doctor. Retired for 15 or so years, he still goes to Grand Rounds at 91 years old to learn and talk shop. Besides my mother, his only true love was and still is medicine. After he served on an army hospital ship in the South Pacific, he opened a small office in the Bronx.

Most of his patients came and went like they do in most physicians’ offices. One couple was different.  Harry was a strapping Scots-Irish trucker who was as easy-going as a man could be and as hardy as an oak tree; his wife, Irene, was as delicate as a porcelain tea cup and a consummate worrier. They came in for physicals or those occasional minor complaints that fill a family practice, until one day he came down with a fever of unknown origin. (There were far more of those fevers then than there are now.)

They called my father’s answering service in the middle of the night. The phone rang in our home and my father ran out with his medicine bag (he still has it) at 1 or 2 in the morning. He stayed there with them, holding Irene’s hand and doing whatever doctors did for mysterious and dangerous fevers until it broke. It was hours and hours.

The point of the story is not just that Harry got well or that Irene was happy. They became friends. They stopped at my father’s office to say hello, to bring pastries, to help with odds and ends. They started coming to the house for birthday parties and holidays. We called them Uncle Harry and Aunt Irene. And they still went to my father for medical care until the day they moved into a retirement village hundreds of miles away. And even then, they did nothing without consulting my father first.

How would that fare today? I honestly don’t know how most medical doctors would handle it. I suspect that most would avoid it for a number of reasons, not the least of them being liability anxiety. In social work, it is a bit easier to go out on a limb for a patient, to step out of the office for a moment. I have done it more than once—gone to graduations of clients whose families were far away, attended baptisms, stood quietly at memorial services, and walked frightened patients into health care centers when they wouldn’t (or couldn’t) go alone. It sits well with me. And it seems to have been good for them, which is how I measure it. I mind the basics (those three rigid rules) scrupulously, but I leave liability to the side, where it belongs.

Maybe I shouldn’t be so carefree about it, but I believe that proper (meaning spiritual rather than romantic) love—more than technique—is the source of cure. Especially in my work. Maybe not so much in the emergency room…but even there I think a point could be made for it.

I occasionally meet with one M.D., who is also a classical homeopath,  to discuss cases. He has been a teacher and a friend over the last few years. I’ve watched him work and he seems to feel the same way about medical boundaries. I don’t think he walks his patients into advocacy centers, but I’ve seen him attend his patients in his home office with a compassion and warmth that is unique in the business today. He dresses casually. He listens. He offers water or tea. He makes himself available both in terms of time and emotion. I don’t think he frets too much about liability either.

I guess people just have to do what they are comfortable with. If they are afraid of being sued, then perhaps they should take the precautions they need to avoid it. I don’t know if that makes it better or worse. They say we draw in what we fear most. I do know one thing. Harry and Irene lived a long time and they loved my father till the day they died.



The Luxury of Divorce

shadow-danceSince 2008, most of us have been walking budgetary tightropes—cutting a piece off of this, snipping some off of that. For a significant percentage, it’s been a steady slide into fiscal chaos, foreclosures, and fear. For some, it’s just the luxuries that have been eliminated: No more the extended vacation, the new car lease every year or two, or the $400 handbag spree. On all counts, it seems that we are a culture moving from decades of “Want It!” to the more realistic “Need It?” Coupon clipping is in again and most people are more worried about whether they’re going to have a roof over their heads than whether they’re sporting the latest Uggs. It has properly affected every aspect of our lifestyles and, hopefully, our values and priorities. But, inevitably, a change so vast has also affected our relationships.

There seem to be two trends at the same time:

On one hand, with less expendable income, there are less expendable marriages. Our new economic realities may be forcing yet another belt tightening—or heart tightening—process: People can no longer afford to get divorced.

One attorney in White Plains, N.Y., Joy Joseph, Esq., has been a specialist in matrimonial law for many years. In the last six years she has seen a very clear downward trend in the number of divorces:

“For people of moderate means, the economy has had a big impact. It is very expensive to get divorced. Only a part of it is attorney’s fees. The bigger part is that the assets are split or devalued in the process. Usually that’s the house, in which they have very little equity. Plus there’s the risk of losing the partner’s health benefits. They’re afraid to live uninsured. So, they cling to an unhappy marriage because they can’t afford to leave.”

The statistics support her observations: A new paper in the B.E. Journal of Economic Analysis and Policy (*1) shows that as unemployment rises, the divorce rate goes down: For every 1 percent increase in the unemployment rate, the divorce rate goes down by 1 percent.

On the other hand:

The NPR-Kaiser Family Foundation survey (*2) suggests that while divorce is down, discord is up. They reported that high unemployment has contributed to ruptures in many families around the country. They state that more than 20% of all Americans who have been without work for more than a year claim that their close relationships have suffered. More than 30% say their financial difficulties have had a profound negative impact on their partners’ health/well-being.

What does this mean for marriages?

Unfortunately for the truly horrible ones it will mean a forced choice between one hardship and another. I know one woman who has no money, three children, no extended family, and no friends because her violent husband has sequestered her. He has gained control of everything, including the children, through both stealth and steady emotional manipulation. He has made her afraid of leaving even though staying will eventually mean her death. She has begun investigating shelters for her and her children and a life she will have to recreate from the very fundamentals, knowing he may still hunt her down. She stands at this crossroads and trembles.

For others in less dire circumstances, it gets complicated by other matters—both material and immaterial. Another woman I know says it’s about money but as it turns out she has about $30,000 in a bank account, a good getaway car, jewelry, and a small, discrete dog she can easily take with her in a carrying case. She knows people in other states. So, why does she stay with a man who hates her, berates her, and beats her? I asked her point blank and she said it was because she likes her furniture. She’s attached to her stuff. While I know that can be true, I think it’s more.

In my experience, a lot of people, men and women, who suffer in abusive relationships do so because they don’t know anything else and have no vista for hope. Often they were so painfully damaged by earlier relationships, they were made to feel as if they deserved no better. I think in her case, it is that she truly feels unworthy and doesn’t trust her own ability to step away, make new friends, get work, and survive in the world on her own. The stuff is little more than a ready excuse.

Another couple, two women who have lived together for fifteen years but have nothing between them but a mortgage, stay because they can’t sell their home. It has been on the market for two years and they have lived utterly separate lives during that entire time.

Some experts say that this may be a situation that bodes well for couples whose marriages are in the borderland between functional and finished. Necessity is the mother of invention and, they suggest, the necessity of living together can force people to find ways to do so companionably, work out issues, and perhaps find it in their hearts to love one another in ways they had not imagined before.

I think of the few moments I was angry and fleetingly considered baling on my marriage—probably the same time my husband considered a similar solution. What made us stand still and work it through? Admittedly, besides occasional pride and obstinacy, our marriage is very stable. Was it just love, then? Surely love was a good part of it, but I don’t believe it was all of it. I believe the commitment and the difficulty of feathering apart two completely interwoven lives overrode the momentary instability. In being faced with staying, we had to work at it. Easy? Far from it. Humbling. Frustrating. Wearisome. Not easy.

But eminently worth it for us. The process brought us to an entirely new level of intimacy, validating everything the optimists hope for and all that clergy argue: that most of us take the easy way out far too easily and leave before the miracle happens.

However, the data does not support the optimism when it comes to marriages that are fundamentally unstable or violent. To the contrary—the current situation should make advocates of domestic violence prevention quite concerned.

If the Great Depression was any indicator, the divorce rate went down, but incidence of violence in the home went up. According to Stephanie Coontz(*3), a historian and professor of women’s studies at Evergreen State College, when states began to permit no-fault divorces, domestic violence dropped by 20 to 30% and the rate at which husbands were murdered by their wives was significantly lowered. According to her, divorce provides a very necessary “safety valve.”

Joy Joseph stated that her experience supported Coontz’s conclusion: “As a result of their inability to afford full divorces, people are going to mediation, which can be good if there’s something to be saved. But a lot of women get hurt in the bargain because they don’t hire their own attorney. They’ve often stayed home to take care of the kids and the husband is generally the main provider and wields the most power. Despite the social changes of the last 50 years, there’s still a great deal of disparity.

“It’s not good,” she adds. “Financial stressors are one of the biggest reasons people split up. Then couple that with the bad relationship and you’ve got a real problem.”

Coontz and others predict that as the downturn resolves, divorce rates will quickly go back up again, which make some people hopeful.

That statistical prediction strikes me as sad, even if it is necessary or inevitable.

Is it wrong to hope that collectively we can learn something terribly important from this recession? Is it wrong to pray that we begin to realize we are not the things we own, rather the relationships we have and the love we give? While I am certainly not in favor of someone staying in a marriage that puts him/her (or children, especially) at risk, I think it might do us all a bit of good to slow down, to take a bit more time between the fight and the time we scream, “I’m outa here.”



2)     Ibid.


People to Watch: Hudson Valley

Judith Acosta PhotoThis was one of the best welcomes I have ever had, or could hope to have. While I’m still missing New Mexico terribly, this article about Verbal First Aid, The Next Osama, and my general practice as a psychotherapist and homeopath certainly took some of the sting out.

Hudson Valley Magazine People to Watch 2012!


A Personal Case for Homeopathy Part II

00_homeopathy_splashAfter the debate with my last articles on this topic, I find I couldn’t agree with the critics more. Homeopathy is strange and sounds magical. When I try to explain it to people — despite years of study and personal/professional experience — I wind up sounding like my worst woo-woo nightmare, stumbling over words like “energy,” “resonance” and “organism.”

As I stumble, my husband patiently awaits my sound byte, still anxiously hoping I can give him a way to explain what I do to save him from sounding just as ridiculous.

As he is a musician, I put it to him this way: “Think of it as you do of music… notes and chords… entire arrangements of single notes (or combinations thereof) and the spaces between them.”

He looked at me, single eyebrow raised. I had crossed over onto his turf. I’d better know what I’m talking about.

“In homeopathy, you can think of both the human being (or any living creature for that matter) and the remedy as pieces of music. A person comes in for treatment and the disease or pathology is presenting as a song, out of tune with the rest of the person when in a healthy state. We look for a remedy that most closely matches the totality of that pathology’s song. When we give it to the patient, the remedy cancels the disease. A song for a song. Like cures like.”

Eyebrow is lowered. I am momentarily reprieved. “Is it phase cancellation?”

“I’m not sure because it’s not an opposing frequency, it’s a similar one. But maybe the amplitudes are opposing.”

Eyebrow is raised. I realize that I’m back to where I started.

Perhaps an easier way to see it is with this metaphor:

See yourself as a being of a million small crystals, each one with a frequency. When you become ill, some of those crystals change frequency and begin to vibrate or sing out of tune. When we choose a remedy, we choose it to best match those crystals that have fallen out of tune. When delivered, it shatters those sick crystals, leaving only the healthy ones behind.

Admittedly, it is a metaphor, and as such, still leaves a great deal unexplained. I can understand the frustration of allopaths and critics with the obvious absence of hard, linear facts that are repeatable regardless of the person or place. Compared to current pharmaceutical philosophy, making scientific “sense” of homeopathy is like trying to play ordinary billiards in a quantum pool hall.

The problem is that homeopathy is aimed at treating the individual with a single remedy, chosen specifically for him or her. It is not for treating masses of people with the same pill. Twenty people could have the “same” flu, but each one would need a different remedy (not necessarily Oscillococcinum) and be rightly cured because each one would manifest illness in a way that is utterly unique to him-/herself. We always treat the person, not the disease. As such it is exceedingly difficult, if not impossible to replicate homeopathic treatment the way pharmaceutical companies try to do in drug trials.

A Simple Case in Point

My dog, who is not generally considered a good candidate for placebo, was sitting in on a session with a young patient I had been seeing for quite a while. While he was curled up on the couch next to her, he looked up at my patient and she frowned, “God, what’s wrong with him?!”

Without warning his eye had started bulging out of its socket. I was taken aback and instantly concerned. I begged her indulgence and called my homeopathic vet, who is located about two hours from us. He told me to take him for an emergency physical exam at a local hospital.

I asked for an emergency reschedule (she was in no danger and there was no threat to the therapeutic relationship) and rushed him over. After the exam, the local vet ruled out the more terrifying possibilities (rupture, tumor etc…) and pronounced it an inflammation, probably due to a scratch, spider bite or bee sting. She prescribed a bucket full of different pills and ointments.

More at ease now that there was no crisis and my panic had passed, I thanked her and left with just one of the ointments in case I didn’t find the right remedy immediately.

When I got back, I went to the repertory (in a computer, unlike my first homeopathic physician) and made a scrupulous list of his visible symptoms. Obviously I could only surmise how he felt, so I didn’t even try. These were the rubrics I chose for him:

1. Eye, inflammation

2. Eye, inflammation, acute

3. Generals, aggravated on the right side

4. Generals, sudden onset

5. Eye, lachrymation

6. Eye, protrusion with red discoloration.

The remedy was Apis Mellifica, potentized bee venom. This is a particularly straightforward example of how like (when it is potentized, meaning highly diluted to the smallest possible dose) cures like: Venom cancels out venom. Within minutes of giving the dog a few pellets, the inflammation was gone. And it never came back. No other treatment was necessary.

Is it always so straightforward? Hardly. I wish it were. It is especially more complicated when people come in with years and years of emotional suffering, chronic illness, and lists of medications sometimes two pages long. I had one patient on 27 medications because she had been diagnosed depressed. Was she feeling any better? Not in the slightest. It was a long haul to wellness for her with the incredible help of a thorough and patient physician.

Taking someone’s case in this situation takes a great deal more time, sensitivity and patience than a simple inflammation. But the essential idea, the bedrock of the interview is the same: Find the remedy that matches the totality of symptoms, which means understanding precisely what it is in her life, in her experience, in her soul that has led to and expresses the essence of the state she is in. It is not enough to say someone is depressed. The word “depressed” doesn’t really mean anything. To say, on the other hand, as one patient did, that she felt forsaken, was chronically sad because she felt all alone in the world yet she was averse to company — that begins to narrow it down a bit. When she added that she had no will power, yet felt better from a good debate, a challenging puzzle, or a lively conversation (mental exertion ameliorates), we begin to see how “depression” expressed itself uniquely in her. The remedy that patient needed (based on those and other symptoms) was Natrum Silicatum.

Now, just because you’re sad doesn’t mean you should go buy Natrum Silicatum. That is the mistake a lot of people and even poorly trained homeopaths make. It is unlikely that you will receive the benefit she did because her state (remember those crystals) was a Natrum Silicatum state. When it was given, what was unhealthy shattered and left behind only what was vital and strong.

I do not blame the debunkers. Homeopathy is very hard to repeat experimentally precisely because of the way it works: Individually. And so much of its success is in the hands of the homeopath whose task it is to see the patient clearly for who he or she is, to see that particular light, to hear that singular song. This is a hard pill to swallow until you’ve seen it work. But when you have seen it — it’s the easiest one of all.

A Personal Case for Classical Homeopathy



Part 1 of a 2-Part Series on How To Explain (or Not) Classical Homeopathy


The American Sound Bite

Out of nowhere, my husband turned to me and said, “I wish you’d tell me what you do so I can tell other people. They ask me what you do and I can’t explain it.”

“I’m a psychotherapist and a consultant in classical homeopathy,” I stared at him. “You know what I do.”

“But I can never explain it quickly enough. I tell them ‘rebalancing,’ ‘rewiring,’ ‘peeling the skin off onions,’ but then I lose myself. I can’t come up with a simple way to describe it.”

This is the worst problem for a homeopath. How do we explain an exquisitely subtle and complex process in a simple way? Take something so important and put it in a sound bite?

I remember a long time ago having to try to explain Verbal First Aid in five seconds or less for a three minute TV news interview. I totally blew it. I’m not very good at sound bites.

But that is what we want in this country—drive through information, fast-food for the mind. If we can’t eat it in the time it takes to reach for the remote, the opportunity to communicate is lost.

But there is hope, because we do like stories. So, I thought that perhaps the best way to communicate what I do is to share with you a few cases. The first one is my own. The others (in Part II of this article) are patients with their identities protected. I have never shared my own story before, but I do so because I believe its dramatic nature will help you to understand what classical homeopathy can do and why some people are so passionate about it.

The Mysterious Case of the Disappearing Mass

Many years ago, I suddenly developed abdominal pain. I had not been sick in any other way and had no idea what was happening. I went for a gynecological exam and was told I was fine. The pain continued. I went back and after numerous exams was sent from the table to the couch. The psychiatrist sent me right back to the doctor. After about a year of bouncing back and forth with increasingly intense (searing, stabbing) pain, they finally “discovered” a mass several centimeters in width in the area of my left ovary.

At this point, the surgeons were called in. I was scheduled for an emergency laparotomy. As they wheeled me in, the surgeon said to my mother, “It could be cancer.” I was 26.

After surgery, as soon as I stopped vomiting, the doctor told me that it was not cancer. My mother wept. He said it was a streptococcal infection (Strep B) that had created adhesions and that I could forget about having children. He proudly went on to inform us that they had “scraped me clean” and that I’d be on antibiotics for about a month.

I did as I was told. I was raised by a doctor, surrounded by doctors, and had complete faith in the system.

Within a short time a whole new sort of pain emerged, this time, however, deeper. It was more localized, again on the left side. I thought the infection had returned. The pain continued for quite a while. I went to the doctor, but there was no infection. After dismissing it (and me) for at least a year again, I finally wound up in hospital. A cyst had burst. This cycle recurred every few months. They recommended birth control pills, pain pills, and pills I didn’t understand. Nothing helped. By the fourth rupture and hospital visit, they recommended a full hysterectomy.

I sat silently until I could take a deep breath again. I asked if there were no other options. The doctor said, “You’ll just keep getting them and since you can’t get pregnant anyway, this is the best idea.”

I told him I would think about it. He told me not to think too long but looked at me is if I couldn’t think at all.

I called a friend who had been talking about homeopathy. She used a homeopath for herself and had located a homeopathic vet. I asked for more information. She sat with me. She loaned me books. And she gave me the name of a doctor. I decided to at least try something before I let my reproductive center be removed forever.

I told my gynecologist about it. He said, and I quote, “You can use all the weed wackers you want, it won’t help.”

I said, “We shall see.” And I meant “we.” I had no more experience in it than he did. But I wanted some option other than organ removal.

He did not escort me out. He was more than mildly annoyed.

But I was on a mission.


Where the Magic Begins

This is what saved me: a young doctor with a tattered copy of a repertory (the book that is used to look up symptoms and match them to different remedies) and another equally frayed Materia Medica (the book that contains full descriptions of the remedies themselves) in a basement office in New Rochelle, NY.

It was the strangest medical experience I’d ever had. He didn’t examine me the way I had expected. He talked to me. Well, actually, he talked very little. He asked me endless questions: Where is the pain? When does it come on? What happened then? What does it feel like? What makes it better? Do you have any food cravings? Do you kick your feet out of the covers? Do you like other people around you? Are you warm? Cold? What makes you afraid? Anxious? Sad?

He was relentless. Two hours of questions that could not seem more unrelated to me or to my ovaries. But honestly, it was such a relief to have someone listen to me without judgment that I suspended my own.

At the end of the interview, he went into a little closet, pulled out an amber bottle, opened the cap, poured a few pellets into the cap, tipped my head back, and said, “Open your mouth.”

He poured the little pellets under my tongue.

That was my first remedy. It was Pulsatilla, a common flower in highly diluted (potentized) form.

After that, my mood improved slightly but briefly and the physical symptoms did not go away. Instead they shifted and got worse. I’ve learned since then that this can happen when a remedy is close but not a bull’s eye. The symptoms became far more localized and presented with greater clarity. It seemed to me then that it was like a boil coming to a head, collecting the “illness” from a large area and concentrating it so it could be seen properly and discharged. We waited a very uncomfortable month.

After the second interview he gave me Thuja. After that I had a frankly rude aggravation (cystitis) which lasted about a month and the cystic pain completely disappeared. An aggravation is what homeopaths hope for as the sign that a cure is beginning. It is also precisely what allopathic doctors find wholly inconsistent with their training. They are supposed to make symptoms go away, not generate others. But because homeopaths see the human organism as a moving, dynamic system, they believe that this discharge is absolutely necessary. Aggravations are like siphons; they allow previously suppressed diseases or eruptions a way out of the system. In homeopathic philosophy, it is part of the cure.

But I didn’t know that at the time. So I called him and complained, and after he ruled out any dangerous infections, he said “Now, we wait.” I’d call him back, still annoyed, uncomfortable, and worried. And he said, again, “WAIT!”

So, I did. After a while, the “rudeness” was gone and so was all the pain. And after a year I realized so were the cysts. None of it—not the cysts or the strep or any of that pain— has ever come back. More important, perhaps, than the physical relief, was that over the next couple of years I became calmer, more centered. Much of the insecurity that had ruled my life up until that point also seemed to just not be there. I didn’t see it leaving. It was just gone when I remembered to look for it.

That was a very long time ago. All my exams are still splendidly normal and I still have my own organs in my own body.

I went on to need other remedies over time to deal with other issues and wound up with a different remedy as my “constitutional,” the one that seems to fit my overall being. But this is how it started. And it convinced me on a cognitive and cellular level that what I had experienced was more than placebo or fanciful wish-fulfillment. As far as I could see, it could not be a placebo (although that would have been just fine with me at that point), because one remedy missed the mark, but the other did not.  And as far as wish-fulfillment—if it had been up to me, I’m sure I would have wished for instant relief—sans aggravation!

In the follow up article, we’ll look at a couple of other cases to demonstrate the most important principle of homeopathy: like cures like. And hopefully discover the sound bite people need to understand what Hahnemann’s legacy has been.

A Primer in Classical Homeopathy: How to Make the Interview Easier and More Productive


(this is an expanded version of the piece currently on Huffington Post)


I’ve been a psychotherapist for 25 years. I believe it’s an important part of my job to make my clients as comfortable as possible from the first phone contact. Despite all reasonable efforts, though, the first interview seems to still be somewhat awkward and difficult for new patients. Really, it’s very understandable. They don’t know me. They feel vulnerable and unsure because they don’t know exactly what’s expected. They’re sometimes not even fully clear about why they’re there except they know they want to feel better.

The homeopathic interview may be even more of an unknown for some people. Not only does it start with the same “unknowns” as the social work assessment, but it adds some new ones, like the simple but monumental fact that it turns allopathic or “standard” medical practice on its head. You may have called the homeopath to get rid of that recalcitrant psoriasis, but he or she keeps talking about whether you kick the covers off at night, how you feel about injustice, or whether your sadness is worse in the morning or at night.

Knowing what to expect of the process and what your homeopath is hoping to learn from you may make the experience more comfortable and more productive. The following is not a medical manual, but a primer for those looking to work with a classical homeopath. Hopefully, it will give you a good idea of what to expect and how to participate so you get the most out of it.

Preparing Yourself  Philosophically

One of the fortunate aspects of my practice is that I see people more frequently because the primary focus of it is mental health treatment. Even though it also takes physical conditions into account, people almost always call me because they’re sad, anxious, grief-stricken, panicked, or in some way emotionally distressed.

Unless a person comes specifically to be treated homeopathically and has already had some experience with the philosophy and practice of classical homeopathy, I usually anticipate spending at least some time in the first or second session on education. I give material for reading, lead them to the National Center for Homeopathy website, and take as much time as he or she needs answering questions.

What you can do, then, to make the time you spend more efficient and effective when you are actively seeking treatment from a homeopath is to learn a little bit about it beforehand.

In my opinion, the best book for the starting patient is Impossible Cure by A. Lansky. It is written in clear, concise prose and doesn’t fall back on “homeospeak” so you can follow her all the way through. And hers is an amazing, personal story of hope.

The principles of classical homeopathy are the following:

Like cures like.

This is the manner of cure. It is also called the Law of Similars and it is the way all proper remedies are chosen. It means that the practitioner is going to ask you a host of questions intended to draw out information that will help him or her choose the remedy that is most “similar” to your totality of symptoms.

The simplest example of the Law of Similars is what we do when we get grease on our hands. We clean it with soap (or, if you’re out in the garage, Goop), which is little more than fat. The soap removes the grease because it is grease.

In a homeopathic case, it may look like this:  A little boy suddenly gets a raging fever with a pounding headache, dilated pupils, cheeks so red they could be purple and becomes delirious. The remedy a homeopath would choose (and there would be a couple of contenders) would have to produce those symptoms in a healthy person. By giving the remedy that would generate that particular type of febrile state to a person with it, it is cured.

This is why quinine works curatively for malaria—because when it is given to a healthy person over and over, it creates symptoms similar to malaria. Like cures like. This principle goes back to Hippocrates and has been considered by homeopaths as the basis for all true healing.

Hering’s Law.

This is the road of cure in homeopathy. In simplest terms it refers to the way and the order in which the pathology will be healed. Cure moves from top down, from present to past, and from in to out (from the spiritual-mental-emotional down through the organs from most to least important and finally out to discharge in a benign way, e.g., a runny nose, brief diarrhea, fever, or skin eruption).

One remedy at a time.

This is the technique of cure and it is an obvious but overlooked wisdom. If multiple remedies are given too frequently and in too rapid a succession (except in extreme and acute situations), the case can be lost. This is even more true with combination remedies (pharmacy concoctions that include multiple remedies, even those that antidote one another).

It is terribly important to let each one reveal in its time what it must. Some remedies take longer than others. We all respond differently at different times to our environments. Remedies are no exception.

The Nature of Pathology:  Layers

This is not a standard homeopathic “principle” but it’s one that leads me to ask of patients regularly: Patience. We are not out to just make a symptom disappear at the expense of your vitality and health. We want to get rid of the psoriasis but not at the expense of seeing you develop uterine fibroids or heart disease.

We want you to be healed. And that takes time. When patients ask me, “Well, how much time,” I have to say, “As long as your organism needs. You’ll tell me how much time.”

The reason for this is that there are layers to everything today. Including pathology.

Western practitioners often mistake the presenting problem for the only problem they need to cure, not having been trained to see the embedding of one pathology over the other or the inheritance one may have received from one’s ancestors.

These are levels of defense. We know this by what happens in our relationships. First bad joke, we get a giggle and a snort. Second bad joke, we get a “cut it out.” Third bad joke, we get kicked in the shins.

It is common knowledge that when an organism is injured, it inflames. It is a mechanism of repair. Homeopaths trace what happens if the injury is not healed (by itself, with proper medicine or the removal of inflammatory agent): the inflammation worsens, leading to induration (hardening). If that is not healed, then the organism resorts to its last defense to save the whole. Thus a cancerous tumor or an ulcer is a result of this process at the genetic level.

In homeopathy there are three basic levels:

The Psoric

Physical level:  Inflammation (fevers, rhinitis, cystitis), pain, spasm, constriction, sensitivity

Emotional level:  Anxiety, apprehension, irritability, anger, sensitivity, insecurity.

The Sycotic

Physical level: Accumulation (calluses, warts), synthesis, deposition, and proliferation

Emotional level:  Hyper-anxiety, fearfulness, hypervigilance, Super-vivaciousness, showmanship (most of American TV), boasting, rigidity, hardness (like calluses), precocity, collection (OCD).  Also the opposite:  too relaxed (a loss of collagen, dropped uterus), looseness in character, overly yielding, shame, frivolousness, bashfulness

The Syphilitic

Physical Level:  Exaggeration, distortion (pointed teeth, curved spine), destruction (cancer), auto-immune diseases, mutations (scoliosis)

Emotional Level: perversion, cruelty, hysteria or mania, (borderline personality disorder, psychosis), distortion of reality and loss of connectedness, delusions, destruction, fearlessness, loss of will to live, loss of senses (smell, sight etc…).

Less Really is More

This concept is one of the major reasons why people have a hard time understanding and choosing homeopathy.

In homeopathy we do not use gross quantities of a substance. We use smaller doses, often below Avogadro’s number—meaning that if you looked at the medicine with an electron microscope you would see nothing. This is also called a “mole.” The mole, as defined by Wikipedia, “is a unit of measurement used in chemistry to express amounts of a chemical substance, defined as an amount of a substance that contains as many elementary entities (e.g., atoms, molecules, ions, electrons) as there are atoms in 12 grams of pure carbon-12 (12C), the isotope of carbon with atomic weight 12. This corresponds to a value of 6.02214179(30)×1023 elementary entities of that substance. It is one of the base units in the International System of Units, and has the unit symbol mol.” (

The way I explain it to patients is this: Homeopathy is an energy delivery system, like a musical instrument or a beating heart or a scream of “fire” in an auditorium. So if the remedy is sulphur 30c, there are no molecules of sulphur in it. It acts on the vital force (and this is important!!!) by energetic resonance. It does not work on our bodies directly the same way that taking an aspirin or steroid does. It seems to work more along the lines of quantum physics than Newtonian law. (Poitevin, Bernard (2005). “Jacques Benveniste: a personal tribute”. Homeopathy 94 (2): 138–139. doi:10.1016/j.homp.2005.02.004.)

The rule of thumb is: The smaller the dose, the more potent.

How does this happen? According to one study, homeopathy works because water has memory.

(E. Dayenas; F. Beauvais, J. Amara , M. Oberbaum, B. Robinzon, A. Miadonna, A. Tedeschit, B. Pomeranz, P. Fortner, P. Belon, J. Sainte-Laudy, B. Poitevin and J. Benveniste (30 June 1988). “Human basophil degranulation triggered by very dilute antiserum against IgE” (PDF). Nature 333 (6176): 816–818. doi:10.1038/333816a0. PMID 2455231.

From Benveniste’s observations, it appears that what’s been in it has a resonant effect. It is similar to the way our bodies remember a trauma. We have body memory even when the trauma is long gone and resonate with similar states or situations, until that original traumatic injury is healed.

As a psychotherapist, I think the tendency of trauma victims to unconsciously set themselves in traumatizing situations again and again is a desire to self-heal in some ways…they are searching for the similar agent. Freud was close to this when he talked about the repetition compulsion. People are often horrified (and not unreasonably) when they engage in unhealthy behavior time and again. They rightly want it to stop. But when it is framed this way and they can see that they have only been seeking resolution, it becomes not only easier to understand but to actually resolve. They feel less guilty with unconscious complicity, less victimized by their pasts and more empowered to move towards change. I’ve seen this understanding alone start to bring about healing even before a remedy has been delivered.

Yegads! No Coffee???

Perhaps the hardest thing for some patients is the need to temporarily give up coffee. I’ve seen patients give up vicodin, birth control pills, marijuana, and essential oils quicker than their daily java joy.  I can absolutely understand it, too. I love coffee. But it is an unavoidable part of the homeopath’s process.

Although I’ve met some homeopaths who do not worry about coffee or other known antidotes (steroids, marijuana, camphor) very much, many of us do take the more conservative path. In general, it’s best to be prepared to have your homeopath ask you to leave the java (and the camphor) aside until you’ve reached a solid plateau of good health. It doesn’t antidote everyone or every remedy, but for most homeopaths it isn’t worth the risk of complicated the case.

What Do They Need to Know THAT For?

Come to the interview ready for a lot of unusual questions. It will not be enough for us to just “name that disease.”

What is important when we look at a patient and what are we going to ask you? We will generally work along the following areas even though we all have different styles and personalities.

Interior function (most important):

Creativity, compassion, forgiveness, centeredness, relatedness, empathy, adaptability, consistency in relationships, integrity/honesty, and consistency between intention and behavior.

Exterior function:

This may not coincide exactly with interior function. However, I believe and have found that our pathologies normally express themselves poetically or holographically. You may recall the expression, “as above, so below.” It is true for us, as well. So we will ask you about situations that reveal your capacity for appropriate behavior (clothing, responsiveness to social cues), money management, job status, time management, socialization, housing.

Physiological function:

Parents’ medical history, personal medical history, current disease state (psoric, sycotic, syphilitic), diet (especially cravings and aversions), exercise, chronicity (how long the problem has persisted), periodicity (how often it occurs and whether there are specific cycles), and modalities (what makes it better or worse).

Spiritual function:

Rigidity, belief system, presence, judgment, fear.

The Art of the Interview

When I teach clinicians and medical personnel (Verbal First Aid, crisis protocols, and alternative healing principles, etc…), I always remind them that questions, no matter how clever or how technically astute, are no substitute for the therapeutic relationship. There is an art to homeopathy that is not “technical” and cannot be acquired solely by accumulating knowledge. I’ve met people who could recite remedies and their exact properties by memory, but could not see a patient in his totality and could not, therefore, come up with the right remedy.

Part of what makes a homeopathic interview successful is the synergy between you, the patient, and your homeopath. There must be a give and take, a relationship of trust, and an open dialogue. If you have questions, ask them. If you have fears, share them. The homeopath must observe and listen, but no one can see what you do not present.

If in fact there is as much art as science to a good case-taking, then you are as much a part of that creative process as your homeopath. Be as open and as honest as you can and you will reap the rewards in the health, vitality and freedom you have always longed for.



Zinc Zonks the Snuffles.

Once again, my colleague has sent out a notice worth posting. I’d like to add a note of my own for those who are using homeopathy: Zinc has also been found to suppress symptoms when the “cold” is an aggravation. Just a word of caution, not a contraindication of any kind to its use. If you have a question, check with your allopathic doctor or homeopath.

This colleague wrote:

The FTC and FDA have come down hard on the makers of zinc-based lozenges and other supplements over the years, hitting them with big-time fines over claims this mineral can beat the common cold.

Well, looks like apologies are in order… because a new analysis finds those claims were spot-on: Zinc can shorten the length of the cold, lessen the symptoms and severity, and even help you avoid getting sick in the first place.

Researchers from the Cochrane Collaboration looked at 13 clinical trials and two preventive studies published over the decades, and found solid evidence that zinc stops the cold virus from replicating.

When the virus can’t reproduce, you get better — and the Cochrane researchers say that, overall, zinc reduces cold duration by about a day.

But that benefit could be bigger — a lot bigger — if you take your zinc the moment the sniffles first hit: Some studies have shown it can slash cold duration almost in half.

The researchers also found that zinc supplements taken over five months slashed the odds of getting colds and reduced school absenteeism in children.

People who took zinc also used fewer antibiotics when they caught colds — but if your doc ever tries giving you or your children antibiotics for the common cold, politely decline… and then find a new doc, or at least a bag of zinc lozenges.

Listen, I’m no fan of the supermarket cold cures that have been fined and punished over the years.

They charge too much and you get too little — often with a sugary coating to boot.

But the question has to be asked: Now that it turns out zinc claims were based on science after all, will the feds refund all those fines and penalties?

Of course not.

File this one under “moral victory.”

Radiating Concern? Some Reassurance…

This is from a colleague who is an expert in biochemistry and human physiology, as well as other sciences. I am going to be posting more from this person in the near future. I will always mention it, but this person prefers to remain anonymous. Suffice it to say, that I would not be posting it on my page if I didn’t believe in its veracity and in the skill of the professional.

Even Bananas Are Radioactive!

Despite U.S. consumers’ growing awareness of iodide pills, Geiger counters and emergency kits in the wake of Japan’s nuclear scare, most people here have little to worry about.

Radiation, is all around us, even inside of us, and it’s perfectly safe for the most part.

ABC News took a Geiger counter around New York City to test different objects and locations. Even in the middle of Central Park, there is always a background level of radiation.

At a food stand in the park, a banana makes the Geiger counter rise a little bit. Bananas contain potassium, which people need to live, but is also radioactive.

At Grand Central Station, the meter on the Geiger counter moved a lot. Grand Central was built with granite and marble, which are both radioactive.

Another activity that exposes people to radiation is air travel.

Every year, just walking around the planet, each individual is exposed to about 3.5 millisieverts of radiation. That’s about 67 chest X-rays, or 134 cross- country plane trips.

Here is a comparison of the radiation levels of everyday items and activities:

Banana: .0007 mSv

Pistachio: .001 mSv

Smoke Detector: .0029 mSv

Abdominal CT Scan: 10 mSv

In the course of a year, a flight crew flying between Tokyo and New York is exposed to 14 mSv of radiation.

Even a full meltdown in Japan would be no reason for alarm in the United States, experts say. If any radiation were to make it here, it would be merely background levels and nothing for people on the West Coast or people in the United States to be concerned about.

In order to get radiation sickness, a person would need to be exposed to at least 1,000 millisieverts of radiation at once. For most people, a fatal dose is about five times that amount; a range of 3,500 to 5,000 mSv of radiation at once is deadly, which would be 10 hours at the Fukushima Daiichi reactor.

To put that in perspective, the radiation levels at the scene of the fire at the nuclear plant in Japan have reached about 400 millisieverts per hour, meaning a person would have to be right there at the fire for two and a half hours to get sick.

Radiation workers have a limit of 50 mSv per year. Workers who’re reaching that limit are being pulled out now.

Another comparison: Three Mile Island came to a 1mSv reading in 1979, while Fukushima Daiichi rated at 400 mSv Monday. Chernobyl, on the other hand, was 16,000 mSv in 1986.

Not all radiation is dangerous, but the levels of radiation we’re hearing about in the plant really are.

The Alternative to Big Pharm…

A new article in Future Health on the use of homeopathy with mental health issues.

Please feel free to comment there or here. Look forward to your thoughts.

Verbal First Aid and Classical Homeopathy

This is an excerpt from a recently published article in Homeopathy Today (2010). It was truly one of the best editing and writing experiences I’ve had. The people at HT are some of the best I’ve worked with.

Verbal First Aid and Homeopathy


Judith Acosta, LISW

Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.”
Leo F. Buscaglia


I recently listened to a CD of a world-renowned homeopath taking a case. Even though I was not in the room with her, I felt her compassion. She asked questions gently but probingly, she was never judgmental, she shared moments of good humor and made it clear by her tone and phrasing that she understood her patient’s suffering. She was available for his questions and answered them with an eye towards educating and healing him.

Listening to her, I recalled the first time I went to a homeopath, also very well known. His manner was quite different: cool, clinical, terse, impatient. He gave the impression that he wanted me to give him answers so he could find the remedy and be done with it. I was brand new to homeopathy and didn’t understand what to expect from  our first meeting, not to mention the treatment. He gave me absolutely no information and would not tell me what remedy he gave me, which is especially unnerving to someone used to the world of conventional medicine. When I called a week later, worried that some of my complaints had gotten worse (this turned out to be an “aggravation,” a temporary worsening of symptoms that actually signals that the remedy is working), he said, “Well, if you want to ruin it with antibiotics, I can’t stop you.”

When I compared notes with others who knew this homeopath they told me, “Don’t worry, he’s like that with everybody. He thinks that if he gives too much information or gets too chummy, he’ll be unduly affecting the course of treatment. He just wants to see what the homeopathic remedy is doing all by itself.”

I encourage you to get the archived edition on the Homeopathy Today website.