A sense of fear waving over me: a case of Pearl
by Gordon Adam
The patient is a woman aged 27. She has a new job to raise £1.5 million for a school building development. She previously taught drama.
Presenting complaint:
Emotional: Feeling very stressed and sleeping badly.
Physical: Back pain. Spinal scoliosis since childhood; has lived with back pain all her life.
Cystitis up to age 12; recurring since her early 20ās.
Family history of prostate and ovarian cancer on her motherās side of the family.
She had cystitis on holiday in Barbados, six months ago. It was treated with antibiotics but the cystitis symptoms recurred several times, with blood in the urine and left-sided lower-back pain. An ultrasound scan revealed a 1.4cm kidney cyst (doctor said it was unlikely to cause the pain). She was referred back to the scoliosis clinic.
She appeared stressed, pressured, animated, and talked non-stop with little prompting about her situation and symptoms.
āSince summer Iāve felt very anxious about work, the house, everything. Iām prone to mild depression. My sleep has been fractured. Iām worried about another cystitis attack. I feel very lethargic, low and exhausted; itās hard to feel motivated to walk or exercise. Iāve put on weight. I feel like Iām on a treadmill. Iām very tense all the time; I havenāt once felt relaxed. If Iām not doing something, I feel guilty. I feel a lot lower down the ladder than I should be. I pride myself in being a bubbly person ā thatās the mask I put on.ā
āØWork: āItās a very stressful environment. Some days itās so hard to get motivated ā I canāt see beyond a bubble of things to do. The support (at work) is good ā moral support, as opposed to professional or practical support. It feels like a lonely job. I feel like Iām muddling through everything ā Iām so tired. Stress spirals in my head, Iām fumbling through panic. My partner is supportive but he runs his own business. If Iām really stressed, itās hard to convey the panic and sheer terror of failing. I donāt feel I can talk to anyone about it. Itās such a huge challenge, it drains me. I get overwhelmed very easily; I have a sense of it being immense and overwhelming.
āI hold on to things emotionally; if someoneās annoyed me itās hard to let go of it. Itās draining.
āI was a nervous child. I suffered from panic attacks and was very shy and had low self-esteem. My self-esteem has recently gone right down.
āI used to have a fear of not being good enough for anyone; now Iāve found someone who thinks Iām good enough; it was love at first sight. Heās wonderful. He reminds me of my father; heās very gentle, caring; we just fit.ā
āØFears: āMy parents dying. My mum lost her parents when she was young; she didnāt get over her mumās death ā she had ovarian cancer and died quite rapidly at 62. My mum is 60 this October ā I find that scary.ā
āØPanic attacks: āI got very anxious after my grandmother died (when she was 6). I got panic attacks. I was so worried about my mum; I knew everything had changed for her. I knew she was depressed. I missed my grandmother so much.
āThe panic attacks got really bad when I was 9; little things drove me to tears, like going to school. I felt incapable of controlling it. Iād cry about random things. It was as if I was going to die, or Iād never see my parents again. I became very clingy towards my parents. I was painfully shy. Leaving home and going to university was like climbing Mount Everest for me.ā After university, she taught English in a small town in Japan for 4 years. She lived alone. āIt was so frightening. I just had to get through it.
āNow (since her 20ās), Iāve been getting panic attacks again. When I was watching a film on my own in Japan: I felt a sweeping sensation of fear that something would happen to me. Itās been worse in the last year ā a sense of fear waving over me. I feel a wave in my stomach; like going over a bridge too fast.
āIām the kind of person to shy away from challenge, but if Iām presented with a challenge, Iāve always done it. Inside Iām feeling āI canāt do itā, but on the outside Iām saying āI can do it!āĀ Ā
What do you most enjoy?
āChocolate and sweet things ā itās a comforter. I love being around friends I find genuine, that are genuinely happy for me and supportive; also my family.
The youth theatre; being around theatrical people (she runs a local youth theatre project). Going to the cinema; romantic comedy makes me feel happy.
Being in my house; alone time; my kitten; holding hands with my boyfriend. The prospect of getting married; the thought of having a family.ā
Perfect holiday?
āIād like to take my partner to Japan, and go to the Pacific Ocean and Australia. You couldnāt be distracted from anything there ā life is so simple. Iād lie on a beach and do nothing, read, chill on the beach. I like being by the sea; itās so relaxing. The sound; its infinity; it goes on forever. If you lived by the sea youād have no choice but to have a carefree attitude, and walk along the beach.ā
Physical symptoms?
āI had cystitis from as early as I can remember until I hit puberty; itās debilitating; it takes a hit on all aspects of my life.ā
Scoliosis was confirmed by her GP when she was 13, she was referred to the orthopaedic hospital; physiotherapy made no difference to the back pain.
Since her holiday in Barbados, she has been getting left-sided lumbar pain: a short, sharp pain; < certain movements, including lifting & bending; > resting left side on a chair; > painkillers (only uses occasionally). Some nights she is woken by a dull ache in the left lumbar area.
Frequent tension headaches from the shoulders and neck up. Her right shoulder feels āas if someone put an arrow in itā; the pain is > massage.
āIām very uptight and tense ā Iām rock solid half the time. I lie in bed and imagine myself falling into sand to try and relax. I feel like corrugated cardboard.ā
What would you like from homeopathic treatment?
"I'd like to feel myself again; to be more lively and more bubbly vs. lethargic.
"I'd like to come back to me. If one thing goes with me it's my self-esteem - it crumbles.
"I need more focus; to be on a straighter path. I want to take control of me again."āØ
ANALYSISāØSeveral themes emerge strongly:
āØ1) Ā Cracking, Crumbling, Fractured, Parts, Hard, Solid, Stress, PressureāØShe feels under pressure, like she might crack up. This language sounds like a mineral ā something hard and solid, under a lot of stress and pressure, cracks, crumbles and fragments into parts. The word āstressā is repeated.
āMy sleep has been fracturedā, āmy self-esteem crumblesā; āparts of me were cracking under the pressureā; āIām rock solid half the time.ā
āØ2) Attacked, Hit, Hitting
Some animal language: āattackedā and āhitā. Panic attacks. āThe cystitis takes a hit on all aspects of my lifeā; āIām very worried about another cystitis attackā; āas if someone put an arrow in itā; āI feel lower down the ladder than I should be.ā
āØ3) Ā In Control vs. Overwhelmed by something Huge & Immense & Very FrighteningāØI had the sense of her being small and vulnerable and being overwhelmed by something much bigger than her coming down on her from above:
āItās a HUGE challenge ā I get overwhelmed very easily; I have the sense of it being immense and overwhelmingā; āI feel Iām muddling through everything ... Iām fumbling through panicā; āstress spirals in my head ... panic and sheer terror of failingā; āI feel out of controlā āa sweeping sensation of fearā; āa sense of fear waving over me.ā
āØ4) Ā Support Ā & IsolationāØShe feels on her own and unsupported: āIt feels like a lonely jobā; she lived alone in Japan, isolated; āmy partner is very supportive but he runs his own businessā; āI love being around friends that I find genuine, and that are genuinely happy for me and supportive.ā
āØ5) The SeaāØWater and the sea come through strongly: āI like being by the sea." ābubble, bubblyā āfear waving over meā, āa wave in my stomach.ā She feels carefree by the sea ā the opposite of the stressed state she is in at the moment!
Physically she has a problem with recurrent cystitis ā a water problem.
āØ6)Ā Problems at times of transition Ā āØChange and transition are difficult times for her: her grandmotherās death; leaving university; living in a different country/culture; holiday; new job.
āØ7)Ā Corrugated Cardboard
āI feel like corrugated cardboard.ā Iād never heard anyone describe themselves this way before. The significance is its connection with ādoctrine of signaturesā.
These themes suggested to me that the remedy should come from a sea animal that has a hard mineral part that crumbles under pressure and that perhaps resembles corrugated cardboard.āØāØPrescription: Pearl immersion 1M
I first encountered Pearl at a seminar by Peter Tumminello in the UK in 2005. He was launching his book āTwelve Jewelsā. I was geared up for a day of gem remedies. I was surprised that a case he presented felt distinctly like a sea remedy. The remedy was Pearl; this was my first lesson in the multifaceted sea/animal/mineral/gem nature of Pearl.
I have since prescribed Pearl many times. Successful cases have mainly been of sensitive young women (20-40 yrs old) working in a solitary situation (vs. part of a team) and struggling with issues of anxiety, self-worth, and identity.
āØMateria Medica
āNegativeā keywords for Pearl include[1]: Boundaries, lack of; Centre, loss of; Confusion; Crumbling; Crushed; Darkness; Blackness; Desolate; Drowning; Erratic; Extremes of emotional reaction; Fear ā overwhelming, panic, terror; Fragmented and disintegrated; Insanity; Insecurity, deep sense of; Irritation; Isolated and alone; Closed / vs Open, too open; Sense of self, loss of; Suffocated, closed in, pressed down, trapped; Shut down, killed and ended.
From the proving of Pearl[2]:
āFrom above me came a dark, black, crushing sensation. I could feel the black, black, black force moving down onto my head. Its power was overwhelming and I was overwhelmed by fear. I was being crushed, killed, suffocated, closed in, trapped, squashed down by a force I could not see or identify.ā [2]āØ
Look at a photograph of the oyster shell to see some resemblance to ācorrugated cardboardā
āØFollow-upsāØAfter 1 month: āI feel a lot lighter, brighter and perkier in myself. The moroseness and depression has been knocked on the head.ā
āAs busy and stressful as my job is, Iām getting on with it, vs. things getting on top of me. I seem to be getting on top of things more. I feel more focused.ā
āI used to take my partnerās stress on ā now Iām not putting up with it.ā
āMy sleep is a lot more solidā (cf. āfracturedā)
āI feel confident and focused within my role. My self-esteem is better.ā
āI can articulate things better vs. rambling and babbling.ā
āMy back is ok. Thereās still slight pain, but it doesnāt get me down so much, everything is so much more positive in my life.ā
āIāve had no more headaches; they were nearly every day before.ā
āIām not as tense; I try and relax. Weāve had a lot more laughs. I feel more rested.ā
āIām doing a lot more things that I want to do. I feel more myself again ā I feel a lot, lot better.ā
After 4 months: āIāve had a couple of work panics but they havenāt completely crippled me. I feel I have a more solid base at work. My successes have solidified my status. I feel more integrated at work ā before I felt very fragmented and that I was āstanding aloneā.ā
āIāve been more assertive so that I donāt get overloaded.ā
She still has back pain. An X-ray showed that her scoliosis has got worse over the last 10 years. She is due to have an MRI scan. Sheās concerned the doctors may want to do a spinal fusion to straighten her spine.
āIāve been very perky and positive, (since the remedy) everything takes on a different meaning. Iāve been fine in myself, happy and content.ā
We talked about yoga and Alexander Technique and osteopathy to help with her scoliosis and back pain.
After 5 months: she was feeling apprehensive about the MRI scan results:
āIām in pain; I think āwill this pain be forever?ā I feel worried and confused; thereās a possibility of having a spinal fusion ā I need to think about the impact that would have. I donāt know whatās going to happen, I feel like Iām in limbo.ā
āØPrescription: Pearl immersion 1M āØ
After 7 months: she says her confidence has been good. She seems light, bubbly, animated.
āI feel a lot more chilled out about my back situation ā what will happen will happen. Iām looking forward to (seeing the orthopaedic consultant) to see what he has to say. I can look at alternatives; Iāve booked to see an osteopath; there are ways to cope with it. Iām not too concerned.ā
Her back pain has been bad: āThe worst itās ever been ā but Iām not worried and confused ā you canāt control what you donāt know.ā
The pain is in the lower left-hand lumbar area, a dull continual ache: the muscles feel very tight; it feels very hard and tender. The pain is < a lot of walking, < sitting, and > lying. TMJ (jaw pain): āI have a clicky jaw and grind my teeth at night; I wake with my teeth clenched. It feels very tense at night.ā Ā
Prescription: Berberis vulgaris 30C
After 9 months: she has been feeling āpositive, in-control, at peace, confidentā. āInvestigating it vs. ānot wanting to know about itā has been more worthwhile than I imagined. Itās answered a lot of questions; itās given me a peace; it gives a bit of closure.ā
She was told she did not need surgery, which ātook a weight off my shoulders.ā
Sheās got engaged to her partner.
After 12 months (by email): āI feel well and seem to be coping. Iām keeping on top of things and doing lots more activity outside of work and that makes me feel great. Iāve taken up running and enrolled on a part-time postgraduate course at university.ā
References: āØ1) āTwelve Jewelsā by Peter Tuminello. [P.296]Ā
2) āTwelve Jewelsā [P.294]
Keywords: overwhelming, fear, waves, panic attack, crumbling, crushed, fragmented, isolated, overloaded, immense, support, self-esteem, beach, sand
Remedies: Pearl immersion.