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Homeopathy is the best type of alternative medicine for psychiatric patients and psychiatric disorders, according to panelists at a workshop that drew an overflow crowd at APA's 1998 annual meeting in Toronto in June.
One factor that makes homeopathy especially appropriate in psychiatry is that it involves getting to know patients in a deep, personal way with which psychiatrists are familiar, said Ed Gogek, M.D., a psychiatrist in private practice in Phoenix.
"When I first heard about it, it made no sense at all," said Gogek. Based on the "law of similars," homeopathy attempts to cure a disease or symptom by administering a substance made of plant or mineral material that tends to cause similar diseases or symptoms. It is a paradoxical idea, he said.
"My view of the law of similars," he continued, "is that if someone is leaning-if you push him in the direction he is leaning-then he'll stand up straight." Homeopathic remedies don't really cure, he noted, but trigger the body's ability to cure.
"My training in homeopathy has been very inspirational," said Sandra Kamiak, M.D., a psychiatrist in private practice in Saratoga, Calif. "It was one of the best things I've done in my entire life."
As a psychiatrist interested in molecular biology, transpersonal psychology, and many other psychiatry-related subjects, Kamiak embraced the holistic approach in homeopathy. She said she finds that homeopathy effectively addresses the mental, emotional, and physical states of a person at the same time.
In contrast to conventional medicine, homeopathy doesn't necessarily want to suppress or eradicate a symptom, said Kamiak. It attempts to work with the body as a whole system to stimulate the defense mechanism and complete the curing process, helping the body clear itself of whatever is causing the symptom. A symptom complex serves a biological purpose, she said, and homeopathy seeks to identify the pattern and the purpose of symptoms.
Symptoms at each level are signposts indicating an imbalance to be cured. When a person is given a remedy, said Kamiak, symptoms subside in order from the most to the least current.
One way to describe homeopathy, she said, is as an "energy medicine" in that it addresses imbalances in the underlying energy system, referred to as chi in Chinese medicine, or electromagnetic energy in physics, said Kamiak. A remedy is a bioenergetic catalyst that initiates the healing process. It is diluted and succussed and causes no side effects. For reasons that are not well understood, the more dilute the solution, the more powerful the remedy.
Homeopathy can be used for minor mental, emotional, and physical problems as well as for more serious illnesses like mood disorders or manic depression, said Kamiak. Some patients can take their regular medications and homeopathic remedies, and others can be treated with only the remedies. Yet psychiatrists using homeopathy for severely ill patients should be very careful and consult with other appropriate practitioners, she said.
To learn about symptoms and determine the best remedy for a patient, a homeopath conducts a long and detailed interview, said Arlin Brown, M.D., a psychiatrist in private practice in Vancouver, Wash. It is similar to the psychiatric interview but has more breadth and depth, he said. Brown said his interviews are 10 pages long and take two hours to conduct, as opposed to his psychiatric interviews, which are three pages long. He uses a passive, psychoanalytic style to get patients to open up, talk, and display different aspects of their personalities.
The goal is to get an individualistic and holistic survey of the patient, said Brown, to understand the patient and match the essence of the remedy to that person. Diagnosing involves taking the essential themes and elements of the case and distilling them to a simple word or phrase that embodies the whole system, a complex task that Brown does using the computer. He then chooses a remedy.
This homeopathic approach has proven effective in various research studies, said Gogek, who proceeded to discuss them. Research on homeopathy should ask the following questions, he said:
Most research to date has been on the first and fourth questions, said Gogek. "Right now," he said, "there's a lot of evidence that homeopathy works, even in high potencies beyond Avogadro's number."
Psychiatrists interested in studying homeopathy can take courses that are four years long from schools in California, Minnesota, and Massachusetts. The National Center for Homeopathy is in Alexandria, Va., and the International Foundation for Homeopathy is in Edmonds, Wash.
Gogek, who studied at the Hahnemann College of Homeopathy in Albany, Calif., said he originally started working with just a few remedies and gradually added others to his repertoire. He now has a homeopathy practice in addition to his psychiatry practice, though he uses homeopathy in his traditional practice whenever it is appropriate or patients are interested in it. Remedies can be used in conjunction with conventional medications and in some instances can gradually replace them, he said.
Gogek and the other panelists urged that psychiatrists use caution, consult with colleagues, and document treatment with homeopathy. It's important to tell patients the risks of going off medications and the limitations of homeopathy, he said.
Many state medical licensing boards see homeopathy as a placebo, said Gogek. They say it causes no harm if the physician is also providing medical care, and, therefore, psychiatrists can use it with their patients.
Panel members expect to see homeopathy grow in popularity in the coming years as public opinion and demand become the vehicles for greater awareness, acceptance, and application. "This is both ancient and future medicine," said Kamiak.
The Web site for the International Foundation for Homeopathy is IFH@nwlink.com.