By Grace Rhoomes.
Adjoa (not her real name) a mother of six children under 9yrs, arrives for a
consultation with one of our ‘trainee homeopaths’ at PISHAM (Premier International School of Homeopathy and Alternative Medicine)
Among other things, I teach case-taking skills at PISHAM, which includes
exploring the individual roles of the observer and case-taker in the therapeutic
relationship. Students participate alternately, as both observers and case-takers
in student clinic, so they can experience first hand, the significance of both
roles in the consultation. ‘Theory alone does not make a homeopath!’
Today, I am the observing the trainee taking the case.
Adjoa’s six children include two sets of twins aged 6yrs and 10 months. Today
Adjoa has arrived with three of her six children, twin boys aged 10 months and
6yr old daughter, one of the older twins.
A couple of things discussed with trainee before we begin i.e. I will take the
children out of the room if the nature of the discussion becomes inappropriate
for them. Adjoa is more comfortable speaking Twi,( my Twi is limited) so the
trainee will assess a natural pause before translating, so as not to interrupt the
natural flow of conversation ,where there are key moments.
“I’ve never been well since the birth of my twins” Adjoa declares, as she walks
into the consultation room, organising her three children , untying one twin
from her back and handing the other twin to her daughter, before sitting down
The family settle in the consultation room, one younger twin on mums lap,
sucking his thumb, the other on the lap of his sister, wriggling and giggling and
altogether seeming a large handful, for the small hands and stature of his sister.
Adjoa sits calmly with a warm but fixed smile on her face, but I immediately
observe sadness in her eyes that betray her overall demeanour. She is attentive
to her children, playful with the twins and mindful of her daughter. The twins
look healthy and happy, one more lively than the other. The daughter, petite ,
The trainee appears a little anxious at how to proceed after taking basic
information. A few hints and words of encouragement from me ( well, we all
need a helping hand!) and trainee visibly relaxes into the process.
Adjoa repeats the ‘never been well since’ statement and that she’s exhausted too.
Adjoa doesn’t ‘ look’ exhausted but her responses to questioning appear ‘flat’
and the trainee seems to have to work hard to engage her in conversation.
Who does look exhausted, however, is the six year old with the wriggling,
giggling twin on her lap, now trying to escape to the floor.
Instinctively, I gather up the twin from his sister, who looks relieved and soon
after, falls asleep on the chair. I wonder if as well as her own tiredness, she
reflects mums exhaustion too. Also how much of a role she has in looking after
her younger siblings
Twin in my arms (still wriggling and giggling!), is now kicking out a rhythm
with his shoes, on the underside of the table. I move further away from the
table and introduce a new ‘silent rhythm’, by swaying in an arc on my swivel
Trainee has managed to stay focused with Adjoa, in spite of this brief activity,
which we all seem to take for granted. I witness increasing rapport, improved
dialogue and a more relaxed situation occurring, between the trainee and Adjoa.
The line of questioning ,about physical health.
‘My’ twin raises the ‘hungry’ alarm, so we pause so the children can eat a light
snack. We all help with this. I swap twins with Adjoa at this point, as my twin
heads towards mum. The other twin less active, and after a munch and a drink,
he falls asleep, helped by the swivel of the chair and the comfort of my lap I’m
The questioning moves to emotions. There’s a heavy silence as Adjoa struggles
to find a situation that makes her happy. The trainee waits calmly, (I wait),
more silence. No verbal reply, but Adjoa rubs noses playfully, with the son on
her lap and glances over at her other two children. (daughter dozing in and out
of sleep) As Adjoa’s shoulders drop, along with her calm demeanour and warm
fixed smile, I now get a sense of the exhaustion she talked about earlier.
The trainee uses this moment to explain the homeopathic process again, holistic
approach, reasons for these type of questions etc. As if this excited some
reserve of energy, Adjoa stands up, manoeuvre’s her son to her back and
secures with her wrapper. She remains standing as if needing a platform to
discuss her sadness, anger and a whole history of emotional pain is revealed.
There is much more than the ‘never been well since……..at the start of the
The trainee puts her pen down, and is attentive and sympathetic, her facial
expressions changing between neutral and mirroring Adjoa’s.
With six year old safely in waiting room watching tv, the consultation ends.
Observation is about the statements/ phrases that clients use, the contradictions
between the spoken word and body language, the thoughts it provokes, feelings
it evokes , the assumptions, the case-takers style, strengths and struggles, a
range of dynamics, learning outcomes and more. It is the interaction between
two people, or in this instance members of a family, the dependence and
interdependence and individual roles within a whole.
One final observation is that Adjoa from Accra, could just as easily be Susie
from South London, or anyone in a whole world of ‘multi-taskers’, with daily
juggling acts and related challenges.
Over to you trainee, time for case analysis!