Here is the next Chapter in Pierre Fontaine’s new book, One Heart, One Mind:

One Heart,
One Mind

Pierre Fontaine CCH

The Case for Healing Autism

Chapter 3
Taking the Case

“Taking the case” is the phrase used to describe the process of finding a
homeopathic remedy capable of reverberating with the totality of
dysfunction. It is often referred to as the constitutional remedy or
simillimum. The case taking process involves collecting all the facts about
the case using various tools such as interview, observation, perception, and a
thorough history. During the case taking consultation the homeopath must
come to an understanding of the Vital Disorder as described by individual
feelings, functions, and sensations, rather than only physical symptoms. A
term for this is “malady” or “mal-a-dit,” which translates from French into
“bad-has-said.” Illness has its own language; symptoms speak to us, the art
of the homeopath is to be able to listen and understand what it tells us. To
elicit and understand what the singular expression of the mal-a-dit is and to
find the corresponding remedy is what a homeopath is constantly focused
upon to achieve.

Normally, it is the afflicted person who gives an account of his condition
and physical symptoms according to what he perceives through his senses.
This is a departure from the allopathic, material approach, which depends on
technology and testing of tissues to find the physical evidence of the disease
in order to treat.

Case taking seeks to understand the disorder as it is verbally expressed and
experienced by the person on the physical, emotional and mental planes. The
goal is to bring the details out to life by facilitating the person to describe his
internal experience in such fine detail so as to, at times, even directly
indicate the correct remedy. This is the way in which the illness, or the
disordered state as we prefer to call it, is identified and matched to a similar
remedy state.

Over the years, case-taking methodology evolved from a linear method to a
more artful yet more accurate and effective consultation. Basic case taking is
a process of attentive listening and precise questioning so as to understand
the physical symptoms of the Vital Disorder, discernable only through the
manifestations of the disorder in feelings and functions as described by
words, gestures and through the senses. Questions follow the Golden Thread
from the chief complaint to deeper levels of individual unique experience.
Let’s take a couple of examples such as constipation and fear of dogs. At a
superficial level, the possibilities of individual experience are limited “I
don’t poop” or “I don’t like dogs.” At the deepest level of Physical,
Emotional and Mental (PEM), information becomes very individualized. For
example, the fear of dogs may have little to do with dogs themselves but
rather might be a fear of extreme physical pain in one individual. In another
individual, the ‘dog’ might be a memory of a verbally abusive uncle. In both
cases the fear of dog leads in very different directions, one goes towards
physical pain, the other towards an emotional matter, while both engender
dramatically different perceptions at their deepest level. With constipation,
the symptoms differences can be as wide as the Grand Canyon. As often
found in ASD children, the stool can be as hard as a rock with dark pellets
that tear the anus; or it can be that the child can go to the potty, even say “it
is coming,” wiggle on the potty and within a minute completely lose the
desire of going because of a complete constriction of the sphincter muscle to
allow the stool to pass. This condition might finally require an enema after a
week though the stool itself is routinely witnessed to be soft. Again, both
examples lead to very different ends and if not investigated properly lead to
the wrong remedy.

Everything the person does or says is important and everything is worthy of
attention in the process of taking the case history: attention but not
interpretation. Case taking becomes distorted when the homeopath goes into
interpretation of common words or expressions or asks leading questions
which can only be extrapolated out of his or her own experience. Avoiding
this type of prejudice and judgment is critical to effective case taking.
For the most part, the evolution of case taking represents an ever-deepening
understanding of how to match states of disorder to remedies. This is called
“like cures like”; from a linear to a more fractal pattern with each symptom
of a chronic, multifaceted disorder acting as a hologram for the entire
disorder. The principles of totality, minimum dose, individualization, and
‘like cures like’ in order to heal suffering through the correct homeopathic
remedy are steadfast, just as the sun is part of the day. Once all the
information is gathered, we mainly pay attention to what is “strange, rare
and peculiar” (SRP). For example, one does not pay attention to painful
joints in arthritis because it is common in arthritis. If the joint pain is worse
after diarrhea (yes, I have seen it) then that becomes a SRP. (Incidentally,
the remedy in this particular case might well be Kali bichromatum.) Or, the
joint pain may drive the sufferer out of bed every night and lead him to
restlessly pace around with a desire to take a hot shower to relieve painful
joints. The pain here is combined with a mental symptom: restlessness and
the desire for hot shower. The remedy in this case might be Rhus
toxicodendron. The possibilities of different symptoms are nearly endless.
That said, this is a rather linear way of taking a case but today we also like to
pay attention to spontaneous gestures and unleashed irrational, unrelated adlibs.
For example, if someone is speaking of a stabbing pain and at the same
time the spontaneous hand gesture illustrating the pain is that of a twisting
motion then it is very unlikely that stabbing pain is accurate and ought not
be taken. Only when the speech matches the hand gesture is the information
accurate and valuable to take into consideration in choosing a remedy. So in
consideration of ASD, the challenge is to find a way to take a case of a child
whose speech is inhibited.

In my own practice, I refined case taking methodology, perfecting what I
call ‘surrogate’ case taking. Surrogacy is a concept I define as going ‘into,
through, and beyond’ the child via an empathic other, most often a parent,
with the goal of finding an accurate remedy. This method evolved in
response to the challenges of taking the case for the ASD population. The
multi-symptomatic nature of the physical presentation, the cognitive
deficiencies at the mental level resulting in poor to non-existent speech and
language skills, and the emotional issues make face-to-face evaluation
difficult, if not impossible.

The challenge is how do we find totality in the multi-systemic disease state
of ASD? How can we identify the individual experience of suffering with a
child who lacks communication skills? How can we come to know the core
of ‘like’ when individually qualifying ASD is so difficult?

Given these questions and the fact the homeopathic consultation and case
history is entirely verbal, the first challenge I faced was how to give voice to
a child whose own capacity to communicate is impeded or whose language
deficits preclude his capacity to portray physical feelings and emotions with
the necessary depth, connection or self-understanding? Parents typically give
the case history when neuro typical children are concerned; a few symptoms,
then we ask the child and parents some questions and give a remedy
accordingly. But ASD demands that parents give not just superficial
symptoms and behaviors, but the very state of disorder of the child; to,
although they don’t know, literally vibrate as the child. Since the parents are
the closest to the child, what I call ‘one degree of separation’, they have the
most potential of relating individual information. I see my role as a partner
facilitating the access to the code.

The process begins with a brief, simple questionnaire comprised of nine
questions completed by the parents (see appendix) prior to the consultation.
The first three questions are rather straightforward:

1. What unusual behaviors, interests, obsessions, tastes, aversions, and
fears does your child have?

2. What makes your child upset or stressed and how does she react
when upset?

3. What makes her calm, what gives her joy, what is she drawn toward
doing, or having?

The behaviors exhibited in ASD are extremely wide and most commonly
denote reactions; understanding the pains and discomfort of what triggers
these reactions is the important part. I liken this to an experience of spinning
wheels, or turning the lights on and off incessantly. We need to get behind
what we see.

One unique aspect of my consultation is that I don’t need to see the child. As
stated previously, there is not much the child can tell me and, perhaps, I am
not the most astute observer. This is possibly a shortcoming, but the main
reason I don’t see the child is because all of the children I see have gone to
so many appointments, they have had to sit as best they could or not, waited
or not, been pricked, prodded, patted on the head with a perfunctory smile
then shoved into a corner with a couple of toys and spoken about in front of
them. This is nothing short of horrible in the best of circumstances. In the
worse cases, total meltdowns occur, papers fly, things get thrown, tempers
flare and embarrassment ensues. I don’t see any reason to participate, repeat
and contribute to this experience. So perhaps observation can give clues but,
in my case, I’d rather not cause the stress to what is already an extremely
stressed child.

One would think that the observation of behavior in order to take the case is
necessary and or useful, but because it is impossible to explore the
experience of the particular behavior in a deep way through direct contact
with the child, it has limited value. A self-stimulation (stim) is a stim; it is
experience of the stim that is meaningful, rarely the outward manifestation.
In other words, flapping is the result of an inner experience, eliciting that is
far more substantial. Given this reality, as I explain later, the parents are the
solution.

The second challenge is to bypass the multi-systemic, gravely varied and
profoundly disturbing symptomatology to reach the core of the case. How
does one manage the fact that autism is more than one disease entity? I felt
that in most cases I had do avoid falling into the vortex of symptoms that are
so vividly displayed in an ASD case: the obvious gut issues, the high levels
of bacteria, fungi, viral agents, the high level of heavy metal toxicity; along
with all that is consistently inconsistent symptomatology. How to find
totality in this? The challenge for me is to keep a bird’s eye view of this
multi-systemic symptomatology yet capture the depth in order to remain
unprejudiced to the totality. Prejudice is the lack of deeper understanding of
a symptom, or not taking a very unique symptom into consideration.

In order to go beyond the morass of symptom presentation it became clear
that I had to find a way to go far deeper than the observable and common
characteristics of children with ASD. I needed to understand the entire state
– the gestalt – indeed, the very root or the core of the child’s suffering
experience. Case taking had to go deeper than noting “flapping” or tantrum
behaviors when the child is told “no,” but rather be a witness of the state of
disorder from the very background upon which the outward symptoms are
held. I refer to this as the canvas where the meeting point of disease and
remedy is illustrated and come together.

When I first began taking case histories of ASD children in 1997, the
methodology was at a standstill. Repertorization was the accepted method of
case analysis and was the only way we as homeopaths knew to take the case.
Repertorization is the traditional approach to case taking that entails
cataloguing physical, mental, and emotional symptoms in order to select a
corresponding remedy. While it is quite effective when dealing with single
very defined conditions, it is not at all effective for such a difficult multifaceted
condition as ASD.

Using this method, individual symptoms are thoroughly described and
documented on the physical, mental and emotional levels and a repertory is
consulted. A repertory is an index that organizes symptoms. The body is
broken down into its parts with sections on “head,” “mouth,” “eyes,” “nose,”
“throat,” etc. down to “feet.” Symptoms are listed under each category.
There is also a very large section on “mind.” Under each heading, rubrics are
listed alphabetically. All kinds of symptoms are listed. For example, one of
the first rubrics under “head” is: “Sensation of air in the head” and three
remedies are listed. Another rubric further down the list is “Sensation, of a
band around the head” and over seventy remedies are listed for that. The
idea is to find the symptom in the repertory and list the remedies that have
been proven to heal this symptom.

When taking the case of a neuro-typical child, the list of complaints is
limited and the chief complaint is easily determined. However, a child on the
spectrum may present with a list as long as 25 different maladies. For this
reason, the repertory became obsolete very quickly when dealing with
autism; there are just too many symptoms. Let’s take another example of
repertorization using constipation, since many ASD children have
constipation that produces little black pellets like sheep dung: Rubric “Stool,
like sheep dung.” There are forty-one remedies listed in the repertory. There
is also a rubric called “Stool, balls” where 47 remedies are listed as well as
some sub-rubrics for “black,” “brown” or “green” balls. Unfortunately,
finding a remedy through such physical symptoms rarely leads to success
because sheep dung-like stool is only a symptom. It does not represent the
inner core of the child in cases of ASD. It does not give voice to the inner
state of the child. One can perhaps affect the “hard knotty stool” with a
remedy listed in that rubric but it does not mean the child’s core ASD
problem will change unless only by chance. The same can be said about
diarrhea, skin issues, or hyperactivity. Very commonly, parents focus on one
problem such as, “If only my child could go to the bathroom on an everyday
basis he would feel more comfortable during the day. I see that he is
hurting but if he were not in so such pain he would be able to focus and he
would make progress.” While that sounds good and possibly logical,
relieving a local symptom rarely brings a change in the core and will not
improve speech in the least.

When the approach is based on a linear, mechanical way of finding a
remedy, such as the approach taken by so-called sequential homeopathy or
CEASE whose method is to give many different remedies in an attempt to
affect as many symptoms superficially as possible, it cannot yield deep
results. Weeding through the immense array of symptoms is key in dealing
with ASD. Superficial remedies give superficial results.
When it became clear that a different way of accessing the child’s deeper
state was needed, I began to explore the idea of the “homeopathic genetic
tree.” This effect has been well documented by contemporary homeopaths in
India who often see families living closely together; the same remedy was
observed to be effective across several generations. For example, during the
consultation for a child, through comments such as, “I understand perfectly
what he means to say…” or, “I know exactly what my child is going through
because when I was a child myself I had the exact same feeling he is trying
to describe.” Such statements can point to a deep and meaningful resonance
between individuals and there is likelihood that the mother, grandmother,
and child all need the same remedy. Through such resonance or empathic
understanding, the mother is able to give details about what the child is
experiencing because she is or has experienced the same thing. The wider
choice of words from the adult makes the discovery process easier. The
effect of a deeper understanding on the part of the parents expands the
choice of remedies greatly and leads to more accurate and deeper acting
remedies.

Ultimately, this method fails for ASD because probing feelings and physical
pains through the adult family members tends to yield better results in cases
of organic illnesses such as asthma, or skin disease, gastro intestinal issues,
auto immune diseases, etc. For autistic children
it is nearly impossible to use the immediate arc of relation due to the lack of
speech and because the parents have not directly experienced autism
themselves or much beyond the generic remark, “He is in his own world and
he wants to come out.” Since parents did not have autism before their child
the lack of arc of relation had to be solved.

I started to focus on the pregnancy for the purpose of finding a matching
homeopathic remedy; not because something wrong happens during
pregnancy but because of the closeness or resonance it brings. When I
started to investigate the physical, emotional and mental planes during
pregnancy and chose a remedy accordingly, the results began to improve. In
the process, I began to understand pregnancy in a completely different light
than what is commonly accepted. The result was the answer to a question I
never thought of asking: what is a pregnancy?

There is a reason why pregnancy represents a unique opportunity to access
the child’s inner state. At the level of the Vital Force (VF), a separate state
begins with its own unique biodynamic state, part of the ‘inflation’ i.e. the
differentiation, process I introduced in chapter 2. Although mother and child
biologically share a body, one biodynamic state is stronger, over-powers and
temporarily replaces the other. It appears that a majority of the time, the
biodynamic state of the child grafts itself onto the mother’s Vital Force (VF)
and by extension onto her body about 65% of the time. In those cases, the
incoming entity’s biodynamic state is the stronger one and temporarily
overcomes the biodynamic state of the mother. The dynamic state of the
child is often stronger simply because it is still connected to “source” which
is dynamically more powerful and pure, that is to say devoid or empty of
prejudice. As this process occurs, the mother becomes completely taken over
by this biodynamic state; her emotions, physical symptoms and mental state
are that of what will be the child and no longer her own. This explains, I feel
rather poetically, why mothers say things like, “I was not at all myself
during my pregnancy.” The mom is completely taken over; she is not in her
own state any longer but is rather imbued by the state that inhabits her child.
Because the change is gradual and it is still, after all, the mother’s physical
body with which she identifies, she still thinks it is her, but really she is no
longer in her own state. From that point on, any experience she describes is
representative of the child’s state; the mother is the one experiencing it in all
of her cells. Everything she feels physically, emotionally and mentally is that
of the child. Sometimes, the switch from one state to the other is brutal;
perhaps it is part of what causes long lasting morning sickness or postpartum
depression. What is occurring is out of her hands; it is mainly the expression
of the dynamis of the growing fetus – the coming child. The pregnancy is an
opportunity to be completely selfless in the sense of being the child.
This deeper, more meaningful understanding of pregnancy happened when a
mother once said “she did not feel at all like herself during the pregnancy”
and then asked me whether that had something to do with her child being
born autistic? It is that question that instantly created this insight. Moms still
ask me that question. Of course, absolutely not! I went on to ask the mom to
describe as much as possible about her physical, emotional and mental state
during pregnancy. Through her particular state during pregnancy, I was able
to get substantial homeopathically useable information to recommend a
remedy. I had reached what seemed like a holy grail of looking through
symptoms to see the fundamental expression of the biodynamic state of her
child but little did I know there would be more to discover.

In my observation in about 35% of pregnancies, the mother’s state is the
same as the state developing within her. In such instance, since the state is
the same as the mother, one can take the present mother’s case and possibly
find the state of the child that way.

The state during pregnancy became crucial to me to find a more accurate
remedy. I understood the state during pregnancy to be a root upon which
information could grow. As I asked about the pregnancy in the greatest
details possible, searching for the most accurate moment of experience of
the state, four key moments during pregnancy were established:

1: The moment the mother ‘knows’ she is pregnant. This can be an
instinctual feeling. Some mothers know they are pregnant right at the
moment of conception, literally when the egg is being impregnated with the
sperm. The moment is often powerfully ingrained but yields little
homeopathically relevant information because the inflation period has not
bloomed yet and the moment is also overshadowed by the arousal of
intercourse.

2: The moment the mother finds out she is pregnant. This is different from
the mother knowing she is pregnant which is commonly the time of taking
the pregnancy test. Here, of course, for the purpose of case taking the depth
needs to be beyond, “I was excited to be pregnant” or, “I was scared.”

3: The entire nine months of pregnancy, especially when the mom felt “not
at all myself.”

“Darling, can you buy some creamed herring?” or, “I want to go to the
beach,” though it is sub-zero temperature outside and ‘normally’ she would
take a sweater with her in ninety degree weather “just in case.” These
seemingly meaningless and absurd events are indications of the state. I love
those events as they stand guard to such wonderful information when
probed. I think it is so much better to understand pregnancy this way than,
“Don’t worry, it’s your hormones,” or, “You’ll get over it.” Once pregnancy
is understood this way it becomes far more meaningful than dismissing and
blaming these results on hormones floating around in the body.

4: The delivery. Whether the pregnancy or the delivery is “good or bad,”
“easy or difficult” does not dictate autism. In fact, no pregnancy or delivery
speaks of autism or any other disease. It is a state that balances between
illness and health. Illness and health are not disconnected from each other
but rather form a “balance rod.” The reason for why the rod leans is
unknown to me. Is it within as I may appear to suggest or without in terms of
environment? Or is it a question of both? For me, reaching the canvas
constitutes the meeting point of within and without so the question is not
asked. Finding a solution overrules.

The key is not to interpret pregnancy. An easy delivery and an easy
pregnancy “It was so easy, I didn’t feel a thing,” is commonly considered a
positive. Yet,, once we scratch the surface it can reflect an “inactive child in
utero,” “minimal kicking” with little or no affect on the mother; “as if
nothing had happened,” may reflect a dull state in the child hence become an
overarching beginning in the search of a remedy. The dullness may be
reflected in the physical body in the form of hypotonia and emotionally dull
like “he never cries.” Seen that way, “dullness” becomes a crucial piece of
information and most likely reflects a central issue in the state of disorder on
all levels. In such a case, “dullness” affords us a branch to hold onto to go
deeper into the characterizing aspects of the dullness. I remember a mother
speaking about her easy pregnancy. When she mentioned it to her doctor or
family members, she was told to “just be happy it’s like that.” She stopped
thinking about it but kept on having a “nagging feeling” noting, “I knew
something was not quite right.” Dullness turned out to be one of the most
prominent qualities of the child. The opposite – or any other configuration –
can be true as well. A flamboyant state, “I wore bright colors and was more
active than I had ever been” can echo a hyperactive child, “climbing on
furniture,” or “waking at 4AM and not needing any more sleep for the rest of
the day.” Anything is possible, and needs to be investigated in order to find
precisely the characterizing nature of the disorder. “Dull” or “hyperactive”
are qualities that can lead us deeper into the core but alone don’t present
enough information to be of value.

Questions are pursued about the pregnancy and depending on what the
mother says and how she says it, I focus on one of the earlier mentioned four
moments to obtain a deeper understanding.

At that point, using the pregnancy improved the results, but the system
needed refinement. To me, the most troubling aspect of going through the
pregnancy with only the mother was that the father was essentially cut out of
the case-taking process. I felt I was beginning to touch something with a
universal quality about it but I was still missing a piece of the puzzle. My
reasoning was that the father or an adoptive parent should also naturally
have equal opportunity as the pregnant mom. I believe the universe is love
and love is unprejudiced so I also believe it is only logical that all have
access to the information albeit instead of one degree of separation it might
be more.

My search to find a way to take the case through the father or parents of the
adopted child marked the beginning of my journey into what I call
“surrogacy.”