Adolescence: Crisis and Management of Creating I-Image
HOMEOPATHY
Dr Anal Mehta MD (HOM); PGDGC; YTTC.
Reader, Department of Organon of Medicine
Pioneer Homeopathic Medical College
Ajwa Road; Vadodara.
Mob: 9824443416,
drabs2110@gmail.com
(Abstract: Adolescence is period of radical changes under hormonal influences and represents its mark on Physical, Psychological, Sexual and Social levels. This is beautifully demonstrated in two simple looking cases of acne and dysmenorrhoea, muscle contraction headache. Acne at puberty bangs on body image tightly linked with self –image has psychological sequelae. Role identity and self- carving process interwoven with family dynamics are vital to understand personality development. Symptoms act as mirror representing mind unfolding with homeopathy holistically. It re – establishes homeostasis and facilitates process of adjustment.)
Adolescence is stage of human life. During this period body undergoes revolutionary changes. The mind and its outlook too experience important changes. The adolescent at the end of this stage resembles like an adult and leaves childhood far behind. Changes include physical, mental, emotional, social etc. If these changes are not channelized properly the individual will not become an ideal citizen, so adolescence should be given due importance.
Adolescence starts at age of 12-13 years. In girls it appears earlier. In girls this stage starts at age of 11 years or so and lasts till 17-19 years. In boys the period begins at age of 12.5 or 13 years and goes up to age of 20-21 years of age.
Physical changes:
Puberty: the onset of puberty triggered by the maturation of hypothalamic-pituitary-adrenal gonadal axes is marked by secretion of sex steroids. This hormonal activity produces manifestations of puberty; traditionally categorized by primary and secondary sex characteristics. The primary sex characteristics are those directly involved in coitus and reproduction: reproductive organs and external genitalia. The secondary sex characteristics include enlarged breast and hips in girls and facial hair and lowered voice in boys. The increase in height and weight.
Precocious or delayed growth, acne, obesity and enlarged mammary glands in boys, small overabundant breasts in girls are some deviations from the expected patterns of maturation. Although these conditions are not medically significant, they often lead to psychological sequelae. They are sensitive to the opinion of their peers and constantly compare themselves with others. Any deviation, real or imagined, can lead to feelings of inferiority, low self-esteem and loss of confidence. Girls are more sensitive to early physical manifestations of puberty than boys.
Case 1 Representing physical changes of adolescence
Name: Miss S A, Age: 16 years, Education: 11th humanities
| Location | Sensation | Modalities | Accompaniments |
| Skin face Since 11-12 years Now increased since 6 months again Around /on nose Chin | Acne Reddish3 papules, pustules, nodules. | A/F first menses with proactive medicines for 15 months menses before2 menses during3 | Irritable 2 Taciturn2 |
| Scalp | Dandruff White, scaly dry No itching | winter |
Physical changes:
Appetite: satisfactory.
Craving: spicy2, pungent2
Perspiration: scanty
Menstrual history: Menarche: 7thstd, moderate flow, dark red, non-offensive,
acne – irritability increases before, during menses.
Thermal state: hot
Life space :
Miss SA is studying in 11th std. her family comprises of parents and one younger brother. Mother gave history about her. Since the first menses, she is irritable and cranky, whereas she was calm by nature before. Her behavior changes when her acne increases. She is worried about her appearance. She doesn’t like if we reject or contradicts her any wish, she becomes angry and will shout, expresses her disliking openly. Her face will be red. Then she will isolate herself and stops talking. If something happens in school she excites easily and reacts fast. She keeps on thinking about the event for a long time. She remains sad and then weeps. Weeping relieves her.
According to the patient, she doesn’t like her face when has acne and especially it is horrible when it is on and around the nose. She doesn’t like to go to school and mingle with friends. Her self-confidence reduces and avoids taking part in ECA.
She shares a good emotional bond with brother and father who is a businessman.
Case discussion:
Psycho-dynamic: In respect to adolescence physical development psychological effect and adjustments. Here with the onset of puberty acne appeared with a temperamental shift of irritability and sulky behavior. Image consciousness and peer identity is major concern of adolescence. In this case her self-confidence was reducing with her perception of her appearance and she avoids mingling with group, performing in eca.. Overall these changes affect the personality.
Homeopathic management :
Considering her anger from contradiction, reserved, sulky behaviour with brooding and sadness, hot Th state and craving for spicy and pungent. She was given Natrum Mur 200, NM 1M one dose weekly with sulphur 1m one dose in between without significant relief. Then I reviewed case considering specific location of acne, kali brom, ars brom and astreas rubens came in picture.
Considering onset of puberty and acne development with all her accompaniments and other symptoms I chose Astreas Rubens 30 daily for two months and one dose of sulphur 1m in between with significant improvement. Then Ast Rub 200 1 dose weekly for next two months. Now no new appearance and her irritability and sulky behaviour are reduced. She took part in annual function this December happily.
Learning: NM was routinistic prescription. Asteream Rubens 200 infrequent repetition might have been better choice than 30 frequent as it has acted as constitutional rather than specific one.
Homeopathic management :
Considering her anger from contradiction, reserved, sulky behaviour with brooding and sadness, hot Th state and craving for spicy and pungent. She was given Natrum Mur 200, NM 1M one dose weekly with sulphur 1m one dose in between without significant relief. Then I reviewed case considering specific location of acne, kali brom, ars brom and astreas rubens came in picture.
Considering onset of puberty and acne development with all her accompaniments and other symptoms I chose Astreas Rubens 30 daily for two months and one dose of sulphur 1m in between with significant improvement. Then Ast Rub 200 1 dose weekly for next two months. Now no new appearance and her irritability and sulky behaviour are reduced. She took part in annual function this December happily.
Learning: NM was routinistic prescription. Asteream Rubens 200 infrequent repetition might have been better choice than 30 frequent as it has acted as constitutional rather than specific one.
Psychological changes during adolescence :
According to Erikson this is fifth stage of development represents issues of identity v/s role diffusion.
Identity v/s Role Diffusion
| Age | Virtues | Psychological crisis | Significant relationship | Existential question | Examples |
| 11-12 to 19 adolescence | Fidelity | identity v/s role confusion | Peers, role models | Who am I? Who can I be? | Social relationships |
It represents
- Struggle to develop ego identity
- Danger of role confusion, doubts about sexual and vocational identity
- Psychosexual moratorium: stage between morality learned by the child and the ethics developed by the adult.
- No dominant mode or zone.
- Major process they undergo
- Re-orientation of world around
- Re-establishing the relationship with parents, teachers, friends, etc.
- Re defining moral Values
- Re assessing the value for Money
- Sensitive to right, duties & obligation as citizen
Experiences received at this stage of development are more or less permanent features or habits in life so it is very crucial.
Case 2: Representing psychological issues of adolescence
Name: Miss R S. Age: 18 years. Education: first-year BBA
| Location | Sensation | Modalities | Accompaniments |
| GUT Lower Abdomen thighs Since menarche Now increased Mind | Colicky, crampy severe pain 3( ganda irritating pain) | >Bending double .2< during and onset of menses3 <before menses3 | Coldness of body with pain2 screams 2 cries2 Giddiness3 Syncope2, fell unconscious Constipation with ineffectual desire Irritable, sad, sulky Tortured as if |
| Head Since childhood Since 10th std Sudden onset Bilateral temporal vertex occiput F: twice to thrice /week Now since one month again F: once or twice / week D: continuous | Mild pain with heaviness Severe pain3bursting hammering sensation (compels to leave classes.)
“TORTURED AS IF” No nausea no vomiting |
< family quarrels
> when alone A/F stress of study A/F anxiety A/F anger <loud noise >sleep from > with allopathic treatment |
Avoids people
Conversation Arguments Weakness of body and mind. |
Physical generals:
Cravings: sour2 sweets 2
Aversion: spicy2
Thirst: less
Thermal state: chilly
P/H: sinusitis 7th -8th std.
F/H: mother: hyper cholesteremia, father: alcoholic, hypertension
Life space :
Family background and birth of patient.
Miss RS lived in joint family comprised of grand-parents, uncle and aunt, cousin brother of her age, her younger sister and parents. Her mother wanted to take divorce immediately after her marriage as she found them very dominating, she wasn’t treated well. He husband was drunkard. They were very rich and big social name but inside the house women were disrespected. There were lots of family conflicts ends up in quarrels. Soon she realised she is pregnant and compromised to live with. When she delivered patient, family wasn’t happy to get her as she was a girl child whereas uncle has son at the same time and they all welcomed him nicely.
Early childhood: mother was very busy in house hold work. Mother used to be sad, weepy, dissatisfied with family environment found she helpless. She was constantly compare with cousin and was given more importance over her. She was criticised and was not given freedom in so many things where her cousin was given. They used to go in same van to school. He threatened patient many times not to declare her good performances and certificates at home. He had beaten her badly whenever she complained about him and grand-parents didn’t scold or punish him but told that “boy will always do mischief”… He used to tear her certificates and notes. They didn’t appreciate her for performances and said ultimately she has to roll roties and criticised her.
All these daily events had lot of effects on her. She said “I’m not loved or appreciated b coz I am girl. I do not like to be girl. I’m unfortunate that I born here. They tortured me daily by this or that way. Tortured means I have to do lot of things against my wish. I don’t like them. Even today I remember all statements what they spoke about me. I cannot forget them. Am I not important? Am I bad? All these thoughts torment me. Although now we r not staying together every day some family conflict happens. I am tired. They didn’t allow me to perform well. I want to go away from this family. I want to study hard wanted to become doctor and independent. I will become successful and want to show my family that girl can do wonders. I want my mom to get rid of this family. I will earn and will take her out of all this.so I am worried about my performance in 10th and this severe headache tortured me and prevented my studies. My menstrual pain is so horrible and it’s like torture. B coz of all these I am not able to concentrate and study well. So I had to take commerce after 10th. But I will go Canada and study hard and will be business woman.”
Current situation :
She doesn’t like to mix with people, prefers to stay alone. Whenever someone in family criticises or comments on her, she feels very bad and gets angry with them. She remains sad for long time. She doesn’t talk and will go in room and cry and brood over about all events. She usually suppresses her anger. If she expresses she uses very critical language that affects relationships. She many times tells her father that he should stop drinking and fighting as his behaviour with mom affects their studies and future. She prays a lot for her good fortune.
She shares good relation with her sister who is bindaas and opposite to her. She never bothers what person tells about her…
Case discussion :
This case demonstrates lot many issues but we will focus on adolescence identity issues here. Since conception there was rejection of child and then non acceptance, gender differences and parental relationship resulted in non-acceptance of feminity, which is also a metaphysical interpretation of dysmenorrhoea. According to Freud, psychodynamics of adolescence depends up on previous stage resolution. Erickson theory indicates role identity V/S role diffusion. Who am I? What I want to be? Here she struggles to establish her identity as a boy and suffers with pangs of menstrual pain. Her tension headache also indicates this stress and struggle. This case shows how our mind reflects in language of symptoms and influences personality development. Holistically homeopathy deals with it.
She was given Nux vom 0/1every 2 hour intervals with significant relief in pain and agony during menstrual pain. She was then given China 1m one dose per month for 6 months. She was better in her headaches and intensity of PMS and pain of menses. Latter she never had syncope attack during menses. Family issues now do not bother her much.
Totality of China and Nux vomica :
| China | Nux vom |
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Adolescence Psychology by Prof. S.P. Chaube
Skills for developing Healthy Reproductive Health by Dr Vranda M N (NIMHANS)
Synopsis of Psychiatry; by Kaplan
The Healing Power of Illness by Thorwald Dethlefsen
