“Cowardice, as distinguished from panic, is almost always simply a lack of ability to suspend the functioning of the imagination.”
Ernest Hemingway
Last weekend (October 29-30) I was at a 2-day seminar on remedies for panic and crisis given by Massimo Mangialavori in Edinburgh, the first time he’s presented this seminar in English. He’s now cutting back on teaching to devote more time to writing, so will not be giving as many seminars in the future.
In keeping with all the cases that Massimo uses in teaching to illustrate the remedies he discusses, the ones he presented here were ones where the patient has responded well to the same remedy prescribed for both acute and chronic complaints over a period of several years. Each of the 3 cases presented during this seminar were so-called ‘small’ remedies, but Massimo emphasises that in his view there are no ‘small’ remedies, just remedies that are well known and remedies that are not so well known. He also places a lot of emphasis on understanding remedy pictures in both their compensated and decompensated states, bringing out both the characteristic coping strategies of the remedies as well as the various triggers which have a tendency to break through those strategies to the fundamental state itself.
Massimo Mangialavori
Panic is a common word that’s used fairly indescriminately to describe a wide range of fearful states. Its principal defining characteristics are that it’s sudden, unexpected, unpredictable, overwhelming, uncontrollable, irrational and a very physical experience. In Massimo’s hands, its definition has far greater precision, allowing it to be distinguished from a phobia, or a state where the fear arises as a consequence of a specific underlying condition. For him, the key characteristic is that it is irrational and apparently unfounded. It’s as if the entire system suddenly has to react against a threat that outwardly doesn’t exist, and the person experiencing it will generally have little or no insight into why it happens. This is different from the state of fear arising from a specific trigger, a fear of something, even though panic will engender fear of the fear itself.
The word originates in mythology, in the nature of the god Pan who symbolises the forces of nature as they express themselves in man; the bestial, the uncontrollable, the untamable, the unconscionable. The son of Hermes/Mercury, who personified the trickster achetype (among others), Pan was mischievous. He delighted in making humans lose control and become disorientated. He was strong, but not destructive. He always struck in daytime and always when people were outside of their familiar environment. As a representative of the immensity of the forces of nature, his name as a prefix also means ‘all’, signifying something immense or all-encompassing – pandemic, panorama, panacea, pandemonium, etc.
This etymology provides the main key to the understanding of the panic states Massimo discussed and presented. At root it is a fear of losing all means of control, of being overcome by the immensity of the forces of nature; specifically as they manifest in and through the body. These forces cannot be grasped by the mind. They are alien to the conception of existence. This is more than a split between self and other – ‘other’ can be conceptualised, visualised, anthropomorphised, which is what we do to ‘aliens’ in the movies – truly ‘alien’ is outside of experience or imagining, hence unpredictable, uncontrollable, disturbing, disorientating, fundamentally and absolutely unknown and unknowable.
The inability to conceptualise – to represent in any form – the nature of the fear, and a strong need to avoid confronting it to be able to maintain a coping strategy, is largely why a psychotherapeutic approach (or one using the mental state to lead a homeopathic prescription) is often unsuccessful. The differentiation between the physical realm as viewed through the biomedical model, which is largely transpersonal (ie. dealing with the common features of human physiology) and the physical realm as viewed through the homeopathic model, which is largely personal (ie. addressing the individual physiology) is key. Massimo referred to the latter as the ‘corporeal’, as opposed to ‘physical’. Conventional approaches to the problem, which don’t recognise the existence of the corporeal dimension, tend to focus on the mental and physical realms. These strategies can palliate, but in most instances are unable to cure because panic states are centred in the corporeal realm, and it’s at this level that therapeutic intervention is potentially successful.
Panic, as opposed to anxious and phobic states, is more common in immature and dependent personalities (irrespective of age), reflected in remedies such as the sea animals, some tree remedies, Nitricum salts, Carbon salts, Kali salts, Arsenicum and its salts and the Lacs. Support – the requirement for, nature of, and attitude to – is a critical factor and an important means of differentiating between various remedy states.
The cases Massimo presented were of successful cures using the remedies Limulus cyclops (horseshoe crab), Castanea vesca (sweet chestnut) and Fraxinus excelsior/americana (European and American ash). These were very clear and presented in his usual style, read by himself and a member of the audience in the form of a dialogue. This is an efficient way of presenting cases in translation, but it would be a helpful addition to have a video of the patients to show all the aspects of the case that a paper presentation alone can’t convey.
Finally Massimo looked at the remedies in the rubric MIND, FEAR, panic attacks, overpowering. In particular he talked about the additions he has made to the rubric, differentiating along the way those remedies where the state of panic is allied to pictures which contrast with the typical panic picture he presented. In the Argentum salts for instance (which, being products of a noble metal, don’t have the undeveloped ego of the typical panic subject), the state relates more to a fear of failure. In Melilotus, it is closely tied to a process of depersonalisation, and in the drug remedies to one of de-realisation.
An excellent and inspiring seminar, but as ever one I left wishing that the clarity and fine discrimination so evident in a distillation of cases and themes produced for a seminar were as easy to find in the ambiguities of daily practice!
Homeopathic seminars often seem to feature amusing little synchronicities, and this one was no exception. Within a short time of beginning, the projector linked to Massimo’s computer started overheating and flashing up the warning “check air flow”. Simultaneously my laptop crashed for the same reason. Appropriate, given the fact that panic can feature flushes of heat,shortness of breath and a sensation of being smothered! After a while and a bit of propping up (= support) to increased the air circulation, the projector and the laptop both settled down. The following day,unpredictably and suddenly, the same thing happened again, with both projector and laptop overheating despite being propped up, and this time with another laptop two rows in front of me crashing for the same reason as well. It’s not something that’s happened at any of the many seminars I’ve been to at this venue before, even on warmer days …
“We experience moments absolutely free from worry. These brief respites are called panic.”
Cullen Hightower
Tags: crisis, homeopathic remedies, Massimo Mangialavori, panic
Nice review, Wendy. I just finished his 7 day seminar on the Solanaceae and related remedies. Intense — and very worthwhile. His style reminds me of studying literature in college (pay close attention to how the character is described and what he/she says), and it does work to help one see the forest beyond the trees.
Thanks Cinnabar. Was that in Boston? Yes I agree, his methods are very useful. I’ve been to 2 other seminars of his — the parasites and the conifers — and have found his insights valuable and the remedy pictures clear and well-differentiated. I like his use of mythology and the Jungian approach to psychology as well.
The rationale behind his protocol with the LM/Q potencies is appealing, though when I’ve tried it out in practice, the response has been much less clear and amenable to straightforward interpretation than the responses he seems to get. Once again, I think its indicative of how we each draw cases to us that resonate with our way of working, and I don’t find the potency strategy works so well for me. Have you, or anyone else, found the same or otherwise?
thanks for the review. Id love to know more about how he arrived at those remedies for the three cases. Any chance of a synopsis of his analysies?
Mostly via the physical (or rather, corporeal) symptoms. His technique, such as it is, seems to involve plugging the general themes and specific pathology into ReferenceWorks (he doesn’t use repertories much any more) and working through what comes up by a process of elimination. His knowledge of remedies means he has a pretty good idea of when he’s looking at a case that’s not any of the well-known remedies, and he works a lot in families — that’s ‘families’ of similar remedies as well as members of the same genus, etc. He’s also compiling a massive database of information which contains pretty much anything whatsoever to do with each remedy listed, so he has a lot of information to hand.
What seems key is the very clear picture he has of what he’s looking for before he starts searching. And if he can’t find it, he’ll sometimes prescribe placebo to begin with to see what else comes up.
With the Fraxinus case, it was a fortuitous accident. He was having no success with his prescriptions after 3 months of trying, and the patient had a flare-up of gout. So he sent him F. excelsior as a gemotherapeutic Rx for symptomatic relief of the gout. The patient was so much better within one hour that he continued with F. americana which was the only Rx he could get in potency.
With the Castanea case (his first of that remedy) he’d prescribed a number of other remedies without success initially. His choice of that Rx appeared to be recognising the similarity to Aesculus but knowing it wasn’t Aesculus. Whether he’d actually prescribed Aesculus as one of the initial Rx, he didn’t say, but in such instances he’ll look for something in the same family.
With the Limulus case, it seemed he already had experience of the remedy. He remarked that the majority of Limulus cases look like Calc-phos and will probably have been prescribed that first.
If I get time over the next while, I’ll ask him if I can publish the remedy summaries he gave along with the paper cases — it makes so much more sense if you’ve got the case as well.
Thanks again. Fascinating and very imspiring stuff. There are very few people who can be as effective working this way but it is something we should all aspire to. I regret not having done his course when I had the opportunity. Its encouraging to know that he gets patients who dont respond to initial prescriptions and that he doesnt get it right first time all the time!