homeopathic pediatrics: The withdrawn child

homeopathic pediatrics: The withdrawn child

The homeopathic literature often focuses on the difficult and contrary child. These are the children who are labeled with allopathic terms such as conduct disorders, attention deficit-hyperactivity disorder, and borderline personality. These children draw attention to themselves in the family and at school, monopolizing the time and concern of all the adults around them. They receive more homeopathic remedies (Hyos., Stram., Anac., Tub., Med., Verat., etc.) and have more office visits than their quieter peers and siblings. The children who internalize their emotional reactions often go unnoticed. Their depression, grief, and fear are lost in the shuffle and noise of the busy family and classroom. They are often brought in by the attentive mother who notices that something is not right.

Children require recognition and acceptance. A child is born with a particular temperament and personality. Parents need to recognize the nature of each individual child, adjust their own expectations, and provide opportunities for learning that consider the child's unique qualities, talents, and emotional makeup. The homeopath is in an excellent position to help parents understand the child's individuality and encourage them to create an environment that will foster growth and strength of personality. When this does not occur, when children are injured, abused, ignored, or misunderstood, they may choose withdrawal as a mode of defense. This recognition of the child includes respect for the child's true nature and purpose. Whether or not parents are aware of these, they can respect the wisdom and integrity of the child's system. Attacks on the system's integrity will result in injury and withdrawal. It is then that remedies such as Silica, Baryta carbonica, Arsenicum album, Staphysagria, Natrum muriaticum, Ignatia, and Thuja may be needed. These remedies can be differentiated by their behavioral manifestations in children and by the events that have initiated the symptoms.

The concept of internalizing and externalizing behavior syndromes arises from the pediatric psychological assessment literature. Through cluster analysis of questionnaire data and clinical descriptions, specific syndromes within these two categories have been depicted. These behavior syndromes are useful when analyzing a case from a homeopathic perspective. They enable an ordered case taking and case analysis process, especially if we correlate these behavior patterns with homeopathic remedies. Tables 1 and 2 list the syndromes within the Child Behavior Profile (see Achenbach, TM Assessment and Taxonomy of Child and Adolescent Psychopathology, Newbury Park, CA: Sage, 1985). Table 3 places some typical homeopathic remedies within this syndrome perspective.

Silica is naturally shy, slow to warm up to new situations, and a natural observer. The Silica child is usually intelligent with advanced development and a quick mind. The child can sum up a situation quickly and give perceptive comments about people. But, there is a stubborn tendency to hang back, watch, and delay their own participation in a new environment. This can give people the impression that the child is slow, but the Silica child is actually quite sharp and sensitive to the surroundings. Because of this tendency to be inconspicuous, the child can be misunderstood by parents. Their perceptivity and natural intellect may even go unnoticed by parents who are less bright than the child or distracted by their own lives.

These children are usually capable and talented, though their withdrawing tendencies slow them down both socially and within the family. It takes a sensitive parent to understand the Silica child, bring out the child's strengths, and to give her/him the room needed to express clearly.

Injuries may cause symptom expression in these Silica children. Emotional trauma may cause them to become more withdrawn. The Silica child may even have difficulty talking to adults or other children. They retreat to their creative activities, and though everyone agrees that they are sweet and cooperative, they develop an aloofness that can be impenetrable to all but the most inquisitive and patient adults around them.

Baryta carbonica, by contrast, is much more afraid. The world is more threatening to these children and they are in hiding. The Baryta carbonica child will hide behind the mother's skirt in a new environment or even when making transitions to familiar places. When family friends arrive at the house, the child will hide behind the couch. At school the child may sit on the edge of the playground throughout the entire recess or a preschooler may sit curled up in a cubby space and require the teacher's entreaties and coaxing to enlist participation in the class. These children do not feel safe in the world. They are sometimes just not bright enough to figure it out. It all seems new and unfamiliar to them and they seem unsophisticated, awkward, unprepared, afraid, and bewildered. This is in sharp contrast with the sophistication of Silica, Natrum muriaticum, and even Phosphorus.

Arsenicum has fears of a different kind. These seem fabricated and unwarranted. They are more obsessive fears. The Arsenicum child must have parents present for reassurance. He/she cannot fall asleep at night without the parents lying in the bed or sitting in the room. This child worries and calculates; is exacting and eccentric. Like the adult Arsenicum who is mortally afraid, Arsenicum children have a fear of annihilation and disappearance. This creates the insatiable need for reassurance. They are afraid of death, afraid of dangers in the world, afraid that their protection will disappear. It is as if their shields of confidence and security in the world have never been adequately formed.

Staphysagria children, on the other hand, have been injured in this world. They are withdrawn because they have been violated and repressed. They harbor resentment because they have not been heard. When adults force these children into a mold, the result is withdrawal and confused, repressed anger. On the surface the child attempts to be cooperative, but at a deeper level resentments about the injury are harbored. The child is stifled, but acquiesces.

Natrum muriaticum children have closed in on themselves. They are observers, but these children calculate to determine their responses. The desire for order does not arise out of fear, as with Arsenicum, but reflects the need for control. They feel emotionally injured and they seek to protect themselves by closing down. This is expressed in the need for order, the interest in clothing styles, social cliques, and the perfectionist tendencies in school. On the other hand, they cannot control their emotional responses, and fits of temper in the form of door slamming and brooding sessions punctuate the quiet, seething, cooperative but tight disposition. One has the sense that the child keeps a lid on things and gets rattled only when the pot begins to boil. To the casual observer and for teachers, these children are perfect models of behavior. Parents, however, are continually challenged by the rebelliousness and the distrust of adults' motives.

Children who need Ignatia are more reactive. They display the active emotional response to the injury. They are visibly upset much of the time. This may occur because of feeling so acutely the effects of emotional trauma. Small children may exhibit screaming, and older children seem constantly upset. A strategy for coping has not been developed and the result is emotional disorder and reactivity. This may occur in children who are abused or traumatized by an event such as a death in the family or a move. The emotional injury that stimulates an Ignatia reaction may take many forms.

An unusual case was an 18-month-old boy who shrieked from frustration whenever he played with toys. He seemed totally disoriented in the world and played quizzically with his toys as if he did not understand the very fact of objects existing in space. He would repeatedly run his fingers along ledges, feeling the edge and staring with fascination. He would knock over a toy, carefully set it upright, then tip it over again, repeating the procedure to understand the process.

His level of frustration was especially worrisome to his mother because he did not seem able to accomplish any small task he set for himself without an emotional outburst. It seemed that he did not understand how to function in this dimension and did not become familiar with the world as other children did. He seemed traumatized by the fact of being here. After receiving Ignatia he became settled, calm, and less frustrated. Repeated doses were prescribed when the behavior arose again at various developmental stages with equally good success. Interestingly, his baby brother began to show some of the same symptoms and he benefited from Ignatia as well. Both boys had a similar demeanor; as if they came from the same realm.

The dynamic in children needing Thuja has recently been described in a fascinating article by Catherine Coulter ("The psychic dimension of Thuja," Journal of the American Institute of Homeopathy, 1993; 86; 197). The article represents a significant event in the classical homeopathic literature because it is unusual in several respects. It raises very important issues about children relevant to their homeopathic treatment, but, it also initiates a realm of thinking about remedies and cases that is new and timely. Readers who do not subscribe to the JAIH will find this article in Ms. Coulter's forthcoming book, Portrait of a Homeopath. This portrait of Thuja supplements those presented by others (see Bill Gray's article, "Thuja -- The great masquerader," Journal of the American Institute of Homeopathy, 1991; 84; 11) and adds new information. In it Coulter describes the typical psychological portrait of the Thuja essence including its guilt, alienation, rigidity, and inadequacy. She does this in her usual lucid and entertaining literary style with many interspersed and illustrative cases. The important point, however, that she makes throughout the article characterizing Thuja, is the disorientation that may occur when individuals have become open to psychic information or other dimensions of reality. She summarizes this point with the following introduction:

"Either because he has been so profoundly injured in this lifetime or, as sometimes happens, from exaggeration of or an imagined victimization, some part of Thuja's spirit has withdrawn from this world and, even if unconsciously, sought refuge in some other sphere of reality where it hopes to feel more at ease. In other words, even while functioning adequately or in fact well on this planet both physically and socially, a certain psychic break, a certain non-integration between his spirit and mortal frame, has already taken place. No longer his old self but not yet understanding his new self (`as if divided in two parts and cannot tell which he is': Kent), he is undergoing the growing pains of transition from existence entirely in this world to an awareness of other dimensions."

Coulter then goes on to explain the mental and emotional symptoms of Thuja from this perspective. The mental confusion and lack of clarity relate to the distress that the traveler experiences as he is caught between two worlds in "alien territory." Thuja suffers from "spiritual bewilderment and psychic disorientation." She views the subjective experiences of Thuja, strange as they may seem to an outsider or the patient him/herself, as valid encounters with other planes of existence. She suggests that many experiences listed as Thuja delusions can be understood more accurately as breakthrough encounters with other realms:

"In the present day and age our understanding of Thuja-like `delusions' is undergoing a significant metamorphosis, and these sensations are beginning to be viewed rather as a confused understanding of paranormal phenomena in subjects ultra receptive to other orders of reality....In other words, that which contributes to Thuja's mental-emotional confusion is having no conventional paradigm or frame of reference through which to process and make meaning of his paranormal experiences. And this lack of satisfying tools for grappling with the psychic dimension, consorting with utter psychic vulnerability and consequent inability to sift and sort out amongst the entities both malignant and benign that randomly bombard him...leaves him with no skill to discriminate in the spirit world."

Coulter goes on to elucidate imaginatively the mentality of the various epochs of western civilization since the Middle Ages, characterizing the last four decades as a Thuja era. Individuals in this era are beset by a range of stressful events and cultural transitions which render them especially susceptible to the disorientation she describes. The modern evolution of spirituality and the discarding of restrictive conventions have led to a precarious state in which individuals are left a little dazed and confused, especially when these forces impinge on their own egos and delicately constructed explanations of reality. This is the point that Coulter makes so eloquently in her forty-page treatise on Thuja.

Children face a particularly difficult set of Thuja circumstances. Coulter raises the issue of vaccinations and their disorienting effects on the system. Thuja's reputation for treating the sequelae of vaccination combined with the neurological symptoms associated with the pertussis vaccine make for interesting speculation upon Coulter's main thesis. She correlates the themes of Thuja in children with those of autism and states of disorientation from physical reality. The themes of Thuja in children are similar to those in adults, that is, they seem tuned out, disengaged, oppositional, psychically sensitive, and learning disabled. She associates the psychic abilities of autistic children with the disorienting effects of vaccination. The screaming episodes following the pertussis vaccine, the withdrawal from the body in SIDS cases, and the neurological damage, retardation, and regression of vaccine injury all suggest Thuja issues. In light of the thesis about autism's relationship to the pertussis vaccine, as so eloquently presented by Harris Coulter (Vaccination, Social Violence, and Criminality, North Atlantic Books, 1991), the themes of autism, withdrawal behaviors, psychic disequilibrium, and Thuja are practical and timely when so many new vaccines are being injected into children.

Vaccines carry the potential to invoke tremendous damage in the body. These are not so much vaccine reactions as vaccine devastation. A child whose system is attacked by vaccines may be thrown into a severe state of disorder. Any child injected with a vaccine recoils in shock, but those who are particularly sensitive or vulnerable undergo a more significant state of neurological, systemic, and psychic catastrophe. The withdrawal that occurs can be drastic and permanent.

This type of reaction is not even seen by allopathic physicians. It is as if they were blinded to the change that occurs in a child after receiving a vaccine. Parents, however, see only too clearly. The difference that they observe in the child is horrifying to them. This is what has caused parents to protest mandatory vaccines and to fight them in the courts.

It is tragic that children are subjected to this assault on their bodies. It is shameful that homeopaths have not publicly expressed their dismay and alarm at the damage done to children in the name of preventive medicine. In fact, the homeopathic community has chosen to back off from the vaccine issue. The Coulters' accusations about vaccines are too speculative, the political implications of confronting the vaccine campaign industry are too touchy, the position of homeopathy in the country's new health care plan is too precarious. Or perhaps homeopaths are lulled into complacency by the denials and reassurances of allopathic vaccine researchers and view the protests against these drugs as a little hysterical.

Whatever the reasons, homeopaths have chosen to withdraw from the vaccine issue. Are we merely to view vaccines as an unavoidable stress of childhood and continue to treat the chronic symptoms that result from their use with constitutional prescriptions for the recurrent ear infections, asthma, and neurological dysfunctions? Or will we come to the defense of our child patients by informing ourselves and parents about the issues, just as we would any other form of injury or abuse?

Sexual abuse of children finally has been recognized as an emotional stress with debilitating consequences. The homeopathic community has brought its own resources to bear on the syndromes and remedies associated with the types of withdrawal resulting from sexual abuse. Can we find the courage to do the same with vaccine injury and its own syndromes of devastation and disease?

TABLE 1: Internalizing Syndromes Syndrome

Example Behaviors Schizoid/Anxious

clingy, nightmares, timid, fears school, anxieties Depressed

lonely, feels unloved, guilty, sulks, feels worthless Uncommunicative

confused, won't talk, self-conscious, secretive Obsessive-compulsive obsessions, stares blankly, hoarding, strange ideas Somatic complaints headaches, dizziness, stomach aches, overtired Social withdrawal

poor peer relations, teased, unliked, withdrawn

TABLE 2: Externalizing Syndromes Syndrome

Example Behaviors Hyperactive

restless, impulsive, acts too young, insatiable Aggressive

cruel, fights, lies, screams, swears, loud, threatens Delinquent

destroys things, disobeys, steals, vandalism, truant

TABLE 3: Homeopathic Remedies Correlated with Syndromes Internalizing

Externalizing Silica

Calcarea carbonica

Tuberculinum Baryta carbonica

Causticum

Medorrhinum Arsenicum

Sulphur

Staphysagria Anacardium Natrum muriaticum

Kali carbonicum

Stramonium Thuja

Calcarea phosphorica

Hyoscyamus Easy/Shy

Difficult

International Foundation for Homeopathy.

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By Randall Neustaedter

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