A 14-year-old female patient came to me on 15^th November, 2003 for treatment of depression and asthma. She stayed with her mother, sister and maternal uncles. Her father was unemployed and stayed in the village. The girl always felt that no one really understood her and that she never got parental love, care, attention and appreciation which aggravated her. She did not like her father as he had left home to go and live in the village for over last many years.
The patient’s mother who had accompanied her for the interview, described her as a hypersensitive girl, who got angry on trivial matters, screamed, shouted and threw things. Nothing pacified her when she was angry and she kept complaining and weeping about her situation. She felt she was not appreciated enough and that her uncles mentally tortured her. The following is a transcript of her case notes:
The case has been edited for brevity and better comprehension. The index to the letter D and P are as follows: D= Doctor, P= Patient.
D: What is the problem?
P: I get angry.
D: Tell me.
P: Actually I don’t want to talk about it. I feel like crying (weeping). Actually, I feel lonely; my mother is a single parent. Though I have a father, he is not staying with us. Mother is working. But I need some attention from her. Day before yesterday, we won an inter-college match in football and this is at the university level and it is not everyday that we win such a match. I expected my mother to come near me, talk to me and appreciate me, but instead she just stood when I came home and said nothing about the match. My maternal uncle too just saw the certificate and left. He didn’t have even a few words of appreciation. They think that I want something big, something expensive. All I want is some appreciation and a bit of my mother’s time.
In the evening I spend time purposely in the house, because I want to talk to her but she is busy all the time or she is tired and wants to sleep. Outside home, I am normal, I’m a peace loving creature, you can say. I don’t like to fight. In fact, I intervene if two people who are fighting. At home I don’t know what happens to me. I hate when my father comes for a month once a year. I feel as if someone is coming and invading our lives.  I’m used to no one attending my school or college functions. I am used to go alone for the functions. I am used to attend and do things on my own. I just need a little appreciation.
At home when I am sincerely doing my work, my two uncles whom I stay with come and interfere. They may not be doing it intentionally but they don’t realize how much they hurt me. We have a small house and if I’m writing something, they say you are disturbing us. What am I doing to them? I don’t understand that. They make me feel so angry and irritated. I can’t tell this to anyone. No one understands me. My mother feels that I am not adjusting and that I am too sensitive. When my father comes my mother gives him attention and not to me. I feel lonely and alone. When I’m with my friends, I’m happy but as soon as I come home, I don’t know what happens to me. I become so angry that I break things in my fit of anger. I am considered of no use. My coaches appreciate me. Yesterday night, I was reading, studying, and doing my home assignment and my uncle asked me to shut the light. What is this? Shouldn’t I do my homework? Shouldn’t I study?
I remember the occasion, when I got my Karate black belt. It was a big ceremony. No one from home attended it. At least they could have told me a few words of appreciation to boost up my confidence. Instead of boosting me they were demoralizing me which made me angry. I tell them to stop doing that but no one listens to me. They argue with me instead. I don’t want to hurt my mother because her health is not good but indirectly I keep hurting her by my erratic behavior and emotional outbursts. I know what is wrong and what is right. If I am not studying or doing my duties, I can understand if you reprimand me and pull the strings (hand gesture – pulling on some reins). When I am doing everything right and when I am not distracted from my path, why are you pulling (hand gesture) the strings? Why they are not giving me space to breathe? I don’t go anywhere out. I have my practice, I go there. I go to my classes and to my college, that’s it. I don’t even go to visit my friends. I go to practice my Karate and spend a lot of time there. Sometimes I play football with my colony friends. That’s it. (Pause)
My sir tells me to be optimistic but what can I do? My home is full of negative energy. Everyone at home is a pessimist. They don’t see what good things I have done, my achievements…. nothing. One small mistake and Oh! I have done a big crime. (Pause) Only during the day of my exams my mother comes, sits beside me and lovingly pats my back so as to encourage me and tell me that I can do well. What is the point? I know I can do it!
D: So how do you feel when there is no appreciation?
P: I feel lonely (weeping).
D: Tell me about this lonely feeling.
P: No one is there. No one cares about me, but this is not true, they care about me, but they are not showing it.
D: What is caring?
P: They should ask me, pat my back and say, “Okay great! You did it.”
D: So what do you feel when somebody pats your back?
P: I feel nice. It boosts up my confidence and I feel I can do it.
D: Then how do you feel when you are appreciated?
P: I feel okay, they recognized my talent. I can do it next time also, if they support me.
D: And if they don’t recognize you how do you feel?
P: I feel sad & depressed.
D: What do you feel in that sadness and depression?
P: Why can’t they understand me? They just think about themselves. My mom just wants to work all the time. Work is more important to her than her child? Why is she working so much? When I ask for her a reason, she says it’s for me and my future. It would be better if she took care of my present than of my future.
D: What is the feeling in that sadness?
P: I feel irritated when no one recognizes me and my talent. I can’t explain that. It is like something very sad. I can’t do anything. I feel like a disabled, that I can do nothing. I am useless.
D: Tell me more about this useless feeling.
P: A whole lot of negative things come into my mind. I know I can do it but when no one appreciates me, something comes over me and then everything goes wrong.
D: What are you good at?
P: Football, Karate, basically all sports and drawing.
D: What all sports?
P: Badminton, carrom… all sports. I am also good at elocution also. I have won many prizes. I am good at studies too and I pass with distinction marks. But I feel I can do better if someone is behind me.
D: What is somebody behind you?
P: Someone always telling me that I can do it instead of someone only pointing at my mistakes and saying, “This is your problem, this is your fault. You can never do it.” Then I lose all hope. I get all negative thoughts. I want someone to tell me positively that I can do it. Then my brain also works that way and I feel confident that I can do it.
D: You said your uncles also pull the string. What is pulling string?
P: I am not doing anything wrong. I am doing everything right and I am not distracted from my path, then why are they pulling me (gesture)?
D: Do that (gesture) – what you did just now?
P: Why are you holding me back? Let me go. Let me go, let me progress.
D: How are they holding you back?
P: Like this.
(Gesture:  Pushing the head, shoulders and arms backwards as if pulled back by string/ reins)
D: So they are pulling your strings & holding you back?
P: Yes, I want to tell them, let me go, let me progress. When I am doing something wrong, hold me.
D: So how do you feel at that time?
P: I feel they don’t want me to progress, that they are jealous of me. When I get a medal or do well in studies, I can see the jealous expressions on their faces.
D:You say that you are a peace loving creature. What do you mean by that?
P: I don’t like to fight. When my friends fight or argue, I just listen to both of them and tell them to stop fighting but at home, I myself land up fighting with all.
D: What dreams you get?
P: Most of the times, I get fighting dreams.
D: Can you describe them?
P: This is a recurrent dream which I get.  I wake up startled. I am with this group of people there is a chaos and everyone is running and I am in a corner.
D: What is the feeling? How do you feel in that situation?
P: Terrible, shaky.
D: What is the feeling?
P: I am afraid.
D: What are you afraid of?
P: I don’t know. I get goose bumps. I can’t explain – it is like a horrible dream, a nightmare which keeps repeating. I feel I might get stuck with those people over there.
D: What could happen if you are stuck with them?
P: Anything, I can come under their feet or hit anyone by mistake. I don’t want to go there.  I can be crushed by anyone’s feet by mistake and anyone can get crushed by my feet. I don’t want that to happen.
D: So you can also crush somebody under your feet?
P: While I am running with that mob and there is chaos, I don’t want that.
D: Why you don’t want that?
P: I don’t want to hurt anyone.
D: Tell me about hurt. What would happen if you hurt anybody?
P: They will feel bad. I don’t want to have those negative feelings about anyone. I mean I don’t want someone to curse me for anything.
D: How organized are you?
P: Pretty much
D: Any interest in plants and trees?
P: Nothing specific
D: What about animals?
P: Like them generally, but no particular fascination.
D: Are you afraid of any animals?
P: Big dogs as I was chased by one. I have not gone to zoo.
D: When you talk about pulling string and holding back, can you think of any animal?
P: Horses and camels.
D: What do you feel about horses and camels?
P: They are being controlled by their rider, according to their will, they are not set free. They are not allowed to do what they want to do. They are made to see what their owner wants to see. The horses have that stuff put near their eyes so they can see only straight, what the owner wants to make them see, nothing else.
D: What else?
P: The horses are not free. They can’t live by their own will. They are used for entertaining people.
(She shifts to talking only about horses and not camels.)
D: So how do those animals feel?
P: They might be feeling depressed. I am not free. I am not in my own environment (patient started weeping).
(She shifts from talking about the horse to talking about herself and she identifies herself with them.)
D: Why are you crying? What made you cry just now?
P: I also felt the same thing.
D: How is your energy level generally?
P: Normal. I got asthma attack few months back due to dust. I had to take a week’s break from school then.
D: How is your stamina?
P: Good. I had to work from my position as well as my other player’s position too. The coach made me play as a stopper and during the match he made me play centre half and made me run.
D: So you are a good athlete? Your running is good?
P: Yes, it was good but it has reduced now because of asthma.
Remedy given: Lac equinum 1M, single dose
Follow up – 23^rd December 2003 (after about 5 weeks)
P: I am feeling very nice. There are no more fights or quarrels at home. There is a good understanding between me, my mother and my uncles. They have changed. They take more interest in me. I am also very calm now. I am much more confident. I have much more stamina when I am playing. Fortunately my breathing too is better and so my game has improved. Did you also give me something for my asthma? My lungs are much clearer. In fact I have no breathing problem.
My anger has gone down. Before, my anger would control me. Now I have control over my emotions. I am concentrating on my work. Surprisingly my uncle has changed. After drinking he used to bother me. Now we crack jokes with each other and we laugh.  They are encouraging me to go ahead with my game.
According to mother:
We at home are just the same as before. We have not changed, but she has changed her outlook towards everything since the past few weeks. I hope she continues this way. She does not get angry like before and she is generally in a very good mood. Even her asthma has gone away almost completely.
Summary of follow up after one year:
She continued to do well. She was selected for the national team in football for under 16 age group. Her academic performance also improved. She was generally in a good mood. She no longer had asthma and her energy levels were also better.  Her father came to their house about 2 months back. She was cordial with him, but not too friendly. She did not stop her mother from meeting him as she felt that her mother was an adult and she knew what was best for her. She did not see any sense in imposing her views on her mother. Her relation with her uncles had dramatically improved.
Analysis:
The patient was very depressed and got very angry. She felt that no one understood her and that no one really listened to her needs. She needed a lot of attention, care and appreciation. She struggled a lot to make her mother and family members happy, but no one understood her. She was pessimistic about her life situation and she lost hope very easily. She needed constant encouragement to boost her confidence. Her confidence level was very low. She needed a pat on her back or someone behind her for encouragement. When her confidence was low she feels useless like a disabled person. She needed recognition from her coaches, teachers and family members.
She loved all sports and she had passion for football. Winning a match was a big achievement for her.
She saw herself as a victim. She felt that the family members were torturing her and not giving her enough breathing space. She feels that her father invaded her space.
According to the sensation approach, a systematic and prolonged study of cases led to a definitive understanding, that when classified at the level of experience, the patients’ experience could be classified into three kingdoms – the Plant, the Mineral and the Animal kingdom. The main experience or the Vital Sensation of the Plants is to do with sensitivity, of being affected and reacting. The main sensation of the Mineral kingdom is all to do with structure, whether I am lacking, if I have to complete myself, or if I am losing my structure; while the main experience of the Animal kingdom is survival. In this patient too we see issues like ‘someone doing something to her’, ‘you versus me’, ‘weaker versus stronger’, ‘victim-aggressor’ which are indicative of the animal kingdom.
The patient came with emotional problems and she kept speaking about it. In the process she came up repeatedly with the use of a metaphor. On probing into it, she started making hand gestures. In the process of case taking, we moved from the emotional level to a delusional level and then to the energy level. She talked about family members pulling the strings. She said, “When I know my duties well, when I am doing everything right and when I am not distracted from my path, why are they pulling my strings? They pull the strings and hold me back.” She made a gesture of bending her head, arms and shoulders backwards. It was similar to a horse whose reins are pulled and who is not allowed to move forward. The energy level expressed by the gesture throws an immediate light on the vital disturbance.
It is amazing that she dreamt of a chaotic situation where people are running everywhere in panic. She is terrified to move as she is afraid that she can crush someone under her feet, which is similar to a horse crushing people under feet in panic.
Lac equinum as a remedy can be understood by the proving of Nancy Herrick who describes horses to be very unhappy and dissatisfied creatures. They are domesticated and exploited for various human needs. There is a central theme of frustration and nothing seems to go right for them. Like the dogs they have a tremendous need to belong and to please their master. They struggle to do their duties, but never get the sense of satisfaction. To please the master they want to do the right things and be on the path expected of them. They are made to do things which are difficult for them and they have to put in a lot of efforts. There is a tremendous fear of failure and subsequent feeling of being useless and incapable. They are very loyal and friendly. They need constant encouragement- a pat on the back so as to say to boost their self-esteem and confidence. People needing this remedy are usually lovers of sports.
Some of the rubrics of Lac equinum:
Confidence, want of (2)
Delusion, hindered (3)
Delusion, neglected, duty, his (2)
Delusion, running out of control, she is
Disharmony in the family, aggravates (2)
(Horses are herd oriented in the wild)
Dreams, sports (3)
Dreams, football (3)
Dreams, unsuccessful efforts
Author: Dr. Mahesh, Faculty and Consultant, the other song
Co-authors: Dr. Sneha Vyas and Dr. Alifiya Merchant, Editors, the other song
 Source: National Journal of Homoeopathy, November 2016.