The Joy of Killing
The New England Journal of Homeopathy
Summer 1996, Vol.5, No.3
By Amy Rothenberg ND, DHANP
I have found that there are many presentations of Anacardium in modern practice. The Anacardium aspect of the patient can be rather subtle, without the outright violence and hatred, excess energy and lack of control, often thought about for this remedy. However, once in a while a patient presents who personifies the lack of moral feeling and the tremendous urge to do violent things. In the case described below, we have such a teenager, who at a very young age began to show signs of this particular nature.
This patient was sent to me by my husband and partner extraordinaire, Paul Herscu, ND, MPH. Before I see one Paul’s patients he will generally tell me his impressions and give me some historical background. With the boy at hand, Paul told me about how he was shy and reserved and seemed rather timid, that Paul had not been able to connect with him very well and that he thought the patient might do better with me. This was atypical as I see many of the adolescent girls and Paul sees most of the boys in that age range. We find this just seems to work better, unless the patient needs a very extroverted type remedy like Medorrhinum or Sulphur – in which case it does not seem to matter who they see!
The case that Paul took revealed the following:
A twelve year old boy complaining of neck pain which goes up to his head and causes a headache. To most questions his reply is “dunno, dunno.”
He has substantial learning difficulties, it was very difficult for him to learn to read. To this date he frequently flips letters. He is not able to draw well; if he does draw it is only of axes with blood and gore.
He gets stomachaches if he drinks too much yet he desires cold drinks.
He is very warm blooded.
His mother had gestational diabetes with him and vomited through 7 months of pregnancy. He was born at term, 9 lbs. He was fine until 6 months of age, when solid food was introduced. He became clingy with many earaches and very irritable as well. He improved greatly on the Feingold diet.
He saw another homeopath and was given Lycopodium 200c at age 4 which seemed to help him in general. Another homeopath gave him Medorrhinum, a few years ago which seemed to help in general, especially with his learning problems.
He has a history of night terrors with lots of screaming and hitting his mother. She would have to hold him tight. These lasted from age 4-6. He had enuresis until age 7.
He is very angry if contradicted or confronted – dictatorial by nature.
He loves snakes. He is a daredevil, which has led to some major bike accidents. He breaks objects on purpose, lies to get candy, and loves violent movies. He say’s outrageous things just to get a reaction.
He has a tremendous amount of energy – he just goes, goes, goes. He desires sweets, salty and cold water.
The mother says that despite all the above mentioned symptoms he is a very sensitive boy.
Paul did not feel as if he had a good handle on the child. This case represents an hour and a half interview – there just wasn’t much there. Since he had previously done well with Medorrhinum and it was the last remedy prescribed, he was given
Medorrhinum 200c, one dose.
Four months later the mother reported that he was still hyper, and worse from food allergies. He became very withdrawn – angry if confronted. He easily gets indignant and slams his door – wants to stay by himself.
He is much worse from consolation.
When he gets angry he becomes nonverbal. If he doesn’t understand something or if he feels misunderstood, he gets very upset.
He has become intense about his personal things – intense about rocks, shells, and coins. He keeps everything just so, very neat. He was obsessed with details. His room is immaculate, he makes his bed every morning without being asked.
The assessment was that he needed something besides Medorrhinum. Paul felt he wasn’t really connecting with the child, he couldn’t figure out what made him tick. He prescribed Natrum muriaticum 200c, without feeling very good about it, and referred the boy to me. The remedy had no effect.
When I take the case for myself, I start anew – fresh slate. I have the general history both homeopathic and otherwise in the chart, but I try to give the patient the benefit of a clear mind and an unprejudiced beginning. What follows is the case I took.
I first saw 13 year old Tony for attention problems, learning problems and allergies. His mother is concerned that he isn’t doing as well in school as he could be. She home schooled him for several years due to religious beliefs but had two years before, sent him to public school, where he really wanted to go.
The mother related much of the following history to me before Tony came into the room. I prefer to do it this way, especially if the problems revolve around the emotional and mental spheres. I don’t think it’s appropriate to talk about all those things in front of the child because it is often awkward and painful.
I bring the child in soon enough and usually see them for some time with the parent – to observe the interaction as well as to have some reality check on the child’s ‘data.’ Of course, this latter point depends largely on the parents’ own clarity and can be more or less useful depending on that. Observation and personal connection remain essentials in all casetaking – that much more so with children.
I will then see the child over age 5 or 6 without the parent for a brief period of time – longer if they are older, willing and comfortable. With many children this alone time with me does not reveal anything tremendously important information-wise, but it often gives a sense of their confidence, poise, ability to communicate etc. On occasion there is something which the parent does not know, that the child will share – sometimes essential to the actual prescription, sometimes not. However, by creating the place for confidentiality and a trusting relationship, information may be offered later down the line, useful for prescribing.
Now back to Tony. The mother reports that she had a normal pregnancy and delivery with this child and that he was fine until about age 6 months. He then began to wake from naps with screaming for up to 2 full hours. She could not remember anything significant that happened preceding this change. He seemed very unhappy and very angry and would make a sort of sound from his throat which the mother described as growling. He had a difficult toddlerhood, with many tantrums and has always been a highly spirited child.
At this point in time, the mother is most concerned about his impulsiveness – with both his mouth and his actions. She is also worried about his learning problems. He is quite behind in school. Academic evaluations contend that he has below average intelligence and that he is severely delayed in reading ability. There were no sensory difficulties found which would impair academic performance, although he has a long history of earaches which were treated with repeated rounds of antibiotics before the age of 3. The mother remembers perhaps ten or twelve such infections. At that time he was put on the Feingold Diet and received great benefit form that approach (which involves removing food coloring, refined foods, additives and preservatives and embraces a natural food regimen).
The mother is worried that he is unnaturally mean to his older brother, both physically and verbally. She often can’t believe the threats of and actual abuse she will observe. These are not things the older sibling submits to, but Tony seems to have a certain power over his big brother. His mother tells me that he can also be abusive with the few friends he has and though he is a social kid by nature, it is difficult for him to maintain friends over time because he is curt and impolite, rough and rude.
The mother also relates that he enjoys killing things and loves to talk about his killing adventures. She also says that he has a poor self-esteem, walks with his head down, seldom joins in family conversations, seeming to be in his own world.
It is not unusual for him to punch and kick people including his parents, siblings and friends, if he is not getting his own way. She reports that he cannot control his temper at all, that he is set off easily and lets both his tongue and his fists fly. He shows no remorse, in fact very little in the feeling department at all. She was embarrassed by his ‘dirty’ mouth as she called it. He threw in the ‘F’ word whenever possible and could seldom get a sentence out without some expletive. She tells me that he has been caught stealing a number of times at a local convenience store and that he never denies it but never says he is sorry.
She worries about what he would become as he got older and stronger and out of the circle of his family. It was easy to understand her fears.
Now what do you do when a kid like this comes into your office? You can’t start the interview with “Hey, kill any neat stuff lately?” No, you must start with some ground breakers and establish some type of rapport. He had some physical symptomatology, so I started there.
I asked him about the cough he had – he said there was a lot of yellow white mucous which he would cough up in the morning. There was nothing dramatic about Tony’s seasonal allergy symptoms, he had some clear runny nose problems in the fall and winter with some frequent sneezing. His eyes would water and his throat would itch. Other than that, he was an extremely healthy child and had not missed any school in the previous two years.
Last week he had a flu and ran a low temperature.
We discussed food cravings (sugar and chicken), and aversions – there were none. He drank 1-2 glasses of water a day.
His sleep was good, in all positions, though he had some difficulty rising in the morning. He never remembered dreams and did not walk, talk or grind his teeth.
I asked him if he had any fears, you know – the dark, high places, that kind of thing. Tough kids like him often don’t admit to any fears. They’ll say they hate something instead of being afraid of it. But if you give a laundry list of possible fears, it can help them feel less like a ‘sissy’ and they might own up to something. He said he was afraid of the dark if he was alone and afraid to talk in front of a group of people.
He then said spontaneously that he got pissed off a lot like if people didn’t understand him. If he was really pissed at home or at school, he would throw something, like a book or lamp or shoe.
I asked him what he liked to do when he wasn’t in school and he said he like to be alone in nature.
What did he do for fun when he was outside, I asked. He liked to do stuff with animals and insects. Now my first thought was that he liked to gather things in nature and make a little collection, categorizing according to type of bug etc. I almost went on to ask about skin or urination or concentration without delving further into his side-interest when I saw out of the corner of my eye – he was looking down and cast his glance sideways while shuffling his sneakers in a coy, nervous kind of way. This was unlike his posturing during the rest of the interview which was rather bold and brazen – legs apart, leaning forward with his head in his hands, gesturing freely, swinging his long hair out of his eyes more often that it seemed necessary.
I got pulled back into the room, front row and center by this switch – his first show of any real emotion after nearly an hour together. I asked what did he do with his specimens? “Oh, well, I’m really into torture,” he responded – just like that.
He came alive as he described his after school activities. “I love to twist the necks off snakes and frogs, and I love to take pencils and stick ‘em through the heads of bugs. And I’ve killed a whole bunch of squirrels with rocks – just bop ‘em on the head and bingo! And did you know you could kill a chipmunk by stepping on its head with the toe of your shoe? Like this.” (Demonstration of the toe technique).
At times like this it is difficult to keep a straight face and not react. I broke the cardinal rule of not expressing shock, horror etc. and said “Tony – that’s gross don’t you feel sorry for all the little creatures?” My words fell on deaf ears. He continued, “I love to kill things and watch them in that last minute, squirming away and then dying.”
I thought this was really sick. As he described, he spent most of his after school time doing things like this. The mother was mostly unaware of the extent of her child’s extracurricular activities and knew very little of his actual behaviors. He relished these times and felt no remorse or guilt or even sense of doing anything wrong. He comes from a very life-affirming family and with good parenting skills.
His overt maliciousness and his total lack of any guilt, remorse or caring pointed the way down the path to Anacardium. The rubrics which came to mind were: Malicious (K.63), Moral feeling, want of (K.68), Anger, violent (K.3) and Cursing (K.17). In particular his low self-esteem coupled with those tendencies leads to Anacardium. I also thought about Tuberculinum, Veratrum album and Medorrhinum for this child. Tuberculinum has the allergic diathesis and the tendency for violence but I have seen these children alternate more in their temperament between really sweet and really awful. This child did not show a sweet side anywhere. There were also no physical generals to confirm Tuberculinum, like grinding the teeth or desiring cold milk.
Medorrhinum had been tried in a number of potencies with no effect. If he had needed Medorrhinum, in a kid this age, entering puberty, we would have seen some sexual acting out or something on the sexual sphere, where there was nothing at all in his case. He lacked any good confirmatories for Veratrum album, but the intensity of his stare and just the sheer yearning for violence, drew that remedy for consideration.
So, it was not that there were no signs of any violent tendencies in the case taken by Paul, rather the whole story, in all its gory detail did not unfold. For whatever reason, this patient did not ‘click’ with Paul. Things like that happen, for all kinds of reasons. They’re not always easy to talk about and it seems very unscientific with regards to homeopathy; yet the art part of our work is there to, and part of the art is connecting to our patients. No one can connect with everyone, so refer when you need to!
Tony was given one dose of Anacardium 200c about 2 years ago. At the first follow up three months later, the mother reported that there seemed to be more harmony in the family and though he didn’t get along with his older brother, they seem better able to live and let live. He was easier to get along with in general and was buckling down at school. He had less blow ups in the family and when he did, they were less intense. He has dropped his animal torturing. Period.
He still swears, though now only when he is really angry and his outbursts seem to be limited to the verbal. He made great strides in regard to his symptoms and temperament within the first few months. There has been little other change since then to show the next remedy.
He still has some hay fever, which goes untreated. He has had some nasty acute diseases especially during the winter. These have been treated by the mother with herbs and vitamin therapy.
It is not uncommon to see more physical problems coming to the forefront as someone with deeper pathology gets better. There has not been a pattern to these illnesses that I feel is reliable enough to prescribe upon, so I haven’t
I would love to give him another remedy, but none has been apparent thus far. I think if I could give him an underlying remedy his propensity toward Anacardium would be taken away and this I would very much like to do. At this point I feel that if he were under a lot of stress he could slip back into an Anacardium state. So I hope the next remedy makes itself known soon – for his sake and for the sake of his community.