Reflections on Case Supervision
By Jackie Clason, RSHom., CCH, HMC
It seemed simple enough. A relatively new homeopath asked me to help her with
some cases. But what I had expected to be a straightforward task turned out
to be a rich and rewarding process.
Mentoring has all the pleasures of treating patients and more. One of the
many things I love about homeopathy is the opportunity to have meaningful relationships
that result in profound evolution of the human spirit. But that evolution takes
place primarily within the internal healing process of the patient, as it should.
To me, the mentoring relationship is even more full: we get the reward of catalyzing
a healing evolution in the patients that we work on together as well as one
of witnessing an intellectual, emotional and often spiritual evolution in our
protégés. That evolution results more directly from the relationship
that is built between the mentor and the protégé, so more of
ourselves is called into play. And that can be a refreshing change after several
hours of being a blank slate onto which our patient’s vital force draws
its self portrait.
Clearly there is great responsibility in this relationship. There are many
ways to teach our protégé so we must use great care to do so
impeccably. Luckily for us, the “clearly defined principles” that
our founder Samuel Hahnemann set forth two centuries ago can be used to guide
us. The mentoring process itself is a homeopathic one.
How does Hahnemann describe the goal of homeopathic treatment? “To restore
the sick to health, to cure...”, (para 1, Organon of Medicine). He continutes;
“The highest ideal of cure is rapid, gentle and permanent restoration
of the health,
or removal and annihilation of the disease in its whole extent, in the shortest,
most reliable, and most harmless way, on easily comprehensible principles.” (para
How do we fulfill that goal? Para 3 states: “The physician perceives
what is to be cured in each individual case of disease, what is curative in
medicines, and how to adapt, (according to clearly defined principles), what
is curative in medicines to what is undoubtedly morbid in the patient ... and
knows the obstacles to recovery in each case and is aware how to remove them...”
How does this translate for us clinically?
First we listen with our full attention, without judgment, giving just enough
encouragement to inspire the patient to reveal herself fully. We seek to clearly
understand the person in front of us, in totality.
We then step back and look at this person as a whole, deducing the individual
constitution of our patient. We assess the state of the vital force and the
disposition of the patient, as well as identifying what needs to be cured.
What is limiting his well being; what are the obstacles to cure? We evaluate
what we can realistically expect as a result of our intervention.
Next, we set to work to find the correct medicine that will strengthen our
patient’s vital force and stimulate deep, long-lasting healing. Using
our knowledge of “what is curative in medicines”, we select the
appropriate remedy in the appropriate potency. At this time we may also attempt
to remove any obstacles to cure that we found. Then in a few weeks, we follow
up and evaluate the action of the remedy.
How do we align these same principles to a case supervision situation? (For
the purpose of this article, I am using the terms case supervision and mentoring
interchangeably as well as she instead of he/she.)
We begin by listening without judgment . We are taking the case of the protégé’s
casetaking and practice. We take it all in; the way the case is taken, recorded
and analyzed, as well as the remedy selection. It is crucial that we keep our
minds open, and stay free of preconceptions so as to let the protégée’s
individuality express itself. As with our patients, we must be diligent to
realize a clear perception.
We then step back to appraise the entire process that we just witnessed and
begin to determine and evaluate the constitution of the protégée’s
homoeopathic mind. What is the state of the “vital understanding” --
that is her understanding of the patient, of the medicines, of the homeopathic
process and philosophy?
Did she get the case? Is the connection with her patient solid? Was her casetaking
skillful enough to obtain the necessary information? Was her analysis accurate,
and if so, did it carry through effectively into rubrics and remedy selection?
If not, what is limiting her, what is missing, what is erroneous? What is her
disposition as a homeopath? As with our patients, this information can be obvious
or can be encoded. We need to look for places where the flow is interrupted
and focus particularly on the flow of healthy clear thinking and perception
(or lack of it). This is a crucial moment: if we look deeply and perceive clearly,
we can unlock important keys to the case of the casetaker. Only then can we
explore the Big Question: what needs to be cured?
Now follows the most challenging, but compelling, part for us. Having experienced
and evaluated the totality of our colleague’s “constitution”,
it is time to choose and administer the proper medicine. Each homeopath is
unique and can arrive at the curative remedy and manage the case effectively
in her own way. The goal is to stimulate the protégée’s
vital understanding with intelligence that resonates with each protégée
as an individual.
Our job, as mentors, is to recognize our colleague’s strengths and
weaknesses and, in each case, to select and administer a few well-chosen “essential
suggestions” to stimulate deeper understanding in his homeopathic mind.
Holding to the spirit of the minimum dose, we need to be mindful to artfully
seek simplicity in our guidance. Ideally we need to only give a calligrapher’s
brushstroke of an essential suggestion to stimulate the “learning mechanism”,
and promote a strengthening of the vital understanding in a way that is rapid,
gentle and permanent.
Naturally, we strive to choose the potency of the suggestions appropriate
to the present state of the vital understanding. If we have not been gentle
or sufficiently skillful, there may be an aggravation, and our protégée
may feel more confused or inadequate, which can undermine the very sense of
empowerment we are trying to catalyze.
There are many ways to connect to the central issues of our patients and likewise
to the central issues of our protégé ‘s homeopathic mind.
We need to know “what is curative in medicines”. There are many
remedies available to the mentor including enriching the protégé’s
skills in analysis strategies, material medica knowledge and translation, case
taking and management, computer and software use.
We need also to be mindful to administer the right “medicine” at
the right time. What is the state in front of you? Is this person struggling
with basic tenets of practice? Or does she need to get to a deeper level with
more confidence during the casetaking? Is there an analysis strategy that the
protégé is unfamiliar with that would fit this case, this homeopath,
perfectly at this moment?
An example of a common essential suggestion delivered at the correct time
would be when the protégée has thought about his case too much
and has lost objective perspective. He may need to widen her view. A question-- “Tell
me who your patient is, in 25 words or less”, “How did you feel
while you were with your patient?” can realign the thinking in an accurate
way, stimulating the clarity of the protégée’s own experience
quickly and effectively.
Throughout, “obstacles to cure” will be discovered in the protégée’s
practice: biases, misconceptions, overuse of certain rubrics and remedies,
important gaps in education and understanding, lack of proper tools and the
basic skills to use those tools. And if you didn’t guess by now, it is
our job to help remove them.
Modeling is probably the mentor’s most valuable tool. The way the mentor
approaches the case as well as the way we approach mentoring itself offers
a perfect opportunity to exemplify homeopathic process and knowledge. Working
on a case together, especially one of the protégée’s, is
a fruitful time to explore more elusive concepts like clear perception, intuition,
patient and remedy evaluation. That experience is more direct than studying
a classroom case and can inspire a shift in the vital understanding on many
levels. A variety of experiences and a grasp of diverse homeopathic approaches
is essential in a mentor, so we can explore which methodologies might suit
this particular homeopath in each particular case.
More so even than in our work with our patients, our mentoring relationship
needs time to evolve and mature as we learn what works best with each individual
homeopath. Therefore, it is essential to conduct a proper follow up. Has the
protégée’s patient responded to the chosen remedy? More
important, did the protégée evolve in her vital understanding?
Did our “prescriptions” as mentors raise the health of the vital
understanding of our colleague? Which of the essential suggestions were most
effective? What does that tell us about our protégée? About our
mentoring? Our understanding and perception deepens as the relationship grows
and we can adjust our guidance to respond to the growth of our protégé.
Perhaps the most significant benefit in mentoring is the extraordinary value
of the mentor just being with the protégée while he is being
a homeopath. If we are wholly conscious, we can provide profound support
solely with our attention and presence. As is true in all relationships,
personal and professional, genuine listening has, in itself, enormous healing
If we are able to be effective as mentors, if we are able to stay true to
the principles we hold so dear, our own homeopathic grounding strengthens intensively.
Mentoring is an extremely valuable, albeit vastly underutilized, resource in
our community. And that is a shame. It is a remarkable process, one that fosters
transformative growth in the protégé, the mentor, and the spirit