Conceptual Understanding of ADHD in Homoeopathy with Emphasis on Mental Symptoms and Rubrics

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a frequently encountered neurodevelopmental condition marked by inattention, excessive activity, and impulsive behaviour, which can interfere with a child’s academic performance, social interactions, and overall development. In conventional medicine, management commonly involves stimulant drugs such as Methylphenidate and Amphetamines, along with behavioural interventions. While these measures may help in controlling symptoms, they often do not address the individual’s deeper psychological state and may be associated with certain limitations.

Homoeopathy adopts an individualized and holistic approach, aiming to understand the patient beyond the diagnostic label by giving importance to mental and emotional characteristics, developmental background, and personal susceptibilities. This article focuses on the conceptual understanding of ADHD from a homoeopathic perspective, highlighting the significance of mental symptomatology, the underlying psychological processes, and the possible influence of antenatal and maternal factors in the evolution of the disorder.

A clinical illustration of a 9-year-old boy presenting with features suggestive of ADHD is discussed to demonstrate the practical application of detailed case-taking, with emphasis on mental evaluation and maternal history. Relevant rubrics have been identified to show their usefulness in forming the totality of symptoms and guiding individualization.

Conclusion: An in-depth understanding of mental characteristics along with developmental and antenatal factors plays a crucial role in homoeopathic case analysis of ADHD, and the use of well-selected rubrics can support accurate individualization in clinical practice.

Keywords

Attention Deficit Hyperactivity Disorder, ADHD, Homoeopathy, Individualization, Hyperactivity, Inattention, mental symptoms, antenatal influence, rubrics, Paediatric psychiatry

Introduction

Autism, also called autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by deficits in reciprocal social communication and the presence of restricted and repetitive patterns of behaviour.

Other common signs include difficulty with social interaction, verbal and nonverbal communication, along with (perseverative) special interests, stereotypic body movements (stimming), rigid routines, and hyper-or hypo reactivity to sensory input.

Autism is clinically regarded as a spectrum disorder, meaning that it can manifest very differently in each person. For example, some are nonspeaking, while others have proficient spoken language. Because of this, there are wide variations in the support needs of people across the autism spectrum. It can occur by birth or develop in the early years of life.

Common Signs And Symptoms

• Avoidance of eye-contact
• Little or no babbling as an infant
• Not showing interest in indicated objects
• Delayed language skills (e.g., having a smaller vocabulary than peers or difficulty expressing themselves in words)
• Reduced interest in other children or caretakers, possibly with more interest in objects
• Difficulty playing reciprocal games (e.g., peek-a-boo)
• Hyper- or hypo sensitivity to or unusual response to the smell, texture, sound, taste, or appearance of things
• Resistance to changes in routine
• Repetitive, limited, or otherwise unusual usage of toys (e.g., lining up toys)
• Repetition of words or phrases (echolalia)
• Repetitive motions or movements, including stimming
• Self-harming

The exact cause of autism spectrum disorder remains unclear even to this date. One reason for this shortcoming could be the lack of understanding of the effect of emotions in the development of the foetus and in turn in the personality profile of the child. As long as we cling to our prejudice of accepting only things that can be produced in a test tube or seen under a microscope, our vision remains myopic when it comes to understanding of the subtle and dynamic causes of diseases. It must be understood that there always exists a difference between causative factors and a precipitating factor behind autism such as the role of vaccinations, hereditary tendencies, genetic mutations etc. but here I shall like to ask few basic questions regarding these supposed causes of Autism:

1. Do all children who are vaccinated become Autistic?
2. Do all the children of autistic parents become autistic?
3. Do all patients with autism show a highly specific gene mutation?

The answer is NO. it is important to understand that there lies something beyond these hypothetical causes, and that is, the INDIVIDUAL. An individual only develops autism if he or she is sufficiently predisposed to it. What decides the predisposition? It is the susceptibility of the developing foetus within the mother’s womb.

Dr. Hahnemann writes clearly about susceptibility in Aphorism 31 of The Organon of Medicine and it states:

       “The inimical forces, partly psychical, party physical, to which our terrestrial existence is exposed, which are termed morbific noxious agents, do not process the power of morbidly deranging the health of man unconditionally; (1) but we are made ill by them only when our organism is sufficiently disposed and susceptible to the attack of the morbific cause that may be present, and to be altered in its health, deranged and made to undergo abnormal sensations and functions- hence they do not produce disease in every one or nor at all times.”

Here Dr. Hahnemann has laid emphasis on physical as well as physical causes behind all diseases (psychological before physical). The master says that we are not randomly brought under the influence of any disease and can only reflect signs and symptoms of any disease if we are sufficiently susceptible to them. Susceptibility or sensitivity is decided within the womb and is a culmination of parental (especially maternal) emotions and thoughts.

In footnote to Aphorism 16 of The Organon of Medicine, Dr. Hahnemann writes:

         “Most severe disease may be produced by sufficient disturbance of the vital force through the imagination and also cured by the same means.”

This aphorism clearly explains the importance of perception, especially erroneous perception in disease development. The cause is always dynamic and it creates a sensitivity to be brought under the influence of the material morbific agents.

Dr. Hahnemann has clearly mentioned this in Aphorism 11 of The Organon of Medicine – “When a person falls ill, it is only this spiritual, self-acting (automatic) vital force, everywhere present in his organism, that is primarily deranged by the dynamic influence upon it of a morbific agent inimical to life.”

Every illness starts with a perception, and it is the perception that in turn determines what pathology or disease state the individual will suffer from.

Role Of Rehabilitation Therapies

Autistic children are sent for speech therapy and occupational therapy. The child starts learning to speak like a parrot. Human child should be able to converse and express its needs on its own. Due to various therapies the child is trained to speak without being aware of what it is speaking.

Human brain is divided into two halves – right and left brain. The right brain which controls the left side of the body is known as the sensitive or the learning brain. The left brain which controls the right side of the body is known as the logical or intellectual brain.

First to develop is the right (emotional brain or learning brain). Right brain becomes a reservoir of experiences on which the left brain (analytical brain) develops later. In Autism, the right brain fails, i.e. there is no reservoir of experiences, based on which analysis and augmentation of intellect cannot be done by the child.

In Autistic children the right brain is underdeveloped, and the left brain compensates. Autistic children are good at intellectual tasks but fail to respond to basic human emotions. They only work as per a logical brain and lack emotional brain or the learning brain.

Rehabilitation centres or various therapies for autistic children work only on the left or analytical brain. These children have no foundation on which the logical brain can grow as their right brain is affected. Homoeopathy, on the other hand, focus on stimulating the learning or sensitive side of the brain, i.e. the right brain. Once the right brain development starts, these children can understand and learn thereon by themselves.

The Importance Of Pregnancy History Of Mothers In Treatment Of Autism Spectrum Disorder – Perception Behind Autism

The mother’s state and perception decide the fate of the child. The symptoms exhibited by the child are a direct reflection of what the mother perceived during pregnancy. Many times the female does not have a sense of belongingness to the family in which she is married. So, the female develops a disconnect to the phase and the people around her. Some females also refuse to change their surnames after marriage which again reflects a disconnect at the level of the psyche for the family is a soil fertile enough for the seed of autism to grow. When the female conceives under such circumstances, the fetus starts to look at the world from the eyes (perception) of the mother. So, the fetus feels that the surroundings are not conductive, and it must avoid connection or contact with them. The home environment and the interpersonal dynamics in the house play a significant role in the aetiology of autism spectrum disorder.

In cases of accidental pregnancies where the mother was not ready to conceive and raise a baby, the fetus develops a disconnect with the parents and displays symptoms of autism. The key in such cases is acceptance of the baby by the parents and thoughts of nurturing and nourishing the child that is to come into this world.

The first product of conception, the zygote, is not merely a fusion of gametes but also a fusion of parental perception. Parents must be ready mentally, physically, socially and financially before planning a baby to avoid neuro developmental anomalies in the child. The foetus must receive welcoming signals throughout pregnancy by both the parents as the thoughts and emotions are transferred to the foetus which in turn shapes the psyche and the soma of the child.

The first trimester is concerned with the anatomical development of the fetus. In the second trimester the physiological functioning gets developed. The last trimester of pregnancy is concerned with the sensory and emotional development of the foetus. It is particularly in the 3^rd trimester that we must inquire to be able to ascertain the reason for development of sensory or cognitive disorders in the child.

At times, the parents want a child of a specific gender. I have seen a case where the mother wanted a daughter because her bedroom was painted in pink colour! In such cases if the child that is going to be brought into the world, is not of the desired gender, it develops a disconnect and fields unwanted by the parents. This can lead to autism as well as many psychosexual disorders in the child.

Even thoughts of abortion in either of the parents during the initial months of pregnancy can give a feeling of being unwanted by the parents in the child and the child may develop a disconnect to the parents within the womb and may later exhibit symptoms of autism spectrum disorder. Many times the mother is not ready for a baby as she is of a very ambitious nature and feels that the child will hamper her professional growth. Any of the parents may be reluctant to take the responsibility of the child because of various reasons. Even in cases of surrogacy where the mother carries a child without any attachment to it may lead to a feeling of disconnect and unwantedness in the child, leading to autism spectrum disorder. The parents should know that the child is absorbing all the thoughts of the parents, even the unsaid ones!

Any kind of destructive influences must be avoided throughout pregnancy as they hamper the psychosomatic development of the child leading to irreversible changes in the mental and physical development of the child.

Homoeopathy is a medical science which has the power to treat such developmental disorders in children. The treatment must begin as soon as possible because time is a very crucial factor in the treatment of such cases. If the child is brought to be a homoeopathic physician before the age of 5 years the prognosis of the case becomes much more favourable. After the age of 5 years complete restoration becomes slightly difficult but the patient can still improve beyond expectations. 

Common Symptoms Of Autism And The Probable Perception Of Mother During Pregnancy

1. Poor eye contact – I better overlook what is happening around me! I cannot see such ill-treatment being done to me any longer! There is no point focussing on these problems and I should avoid looking at them!
2. No speech – It is better I keep quiet as speaking will only aggravate the situation!
3. No hearing – I better turn a deaf ear to these accusations and ill-treatments!
4. Excessive mobility, hyperactivity, restlessness, rocking – I must move away fast or else I shall remain trapped in this situation!
5. Aggression behaviour like biting and striking – How I wish I could just give it back to them! I feel like making their face when I see such behaviour from their end!
6. Repetitive actions and movements – must behave in a programmed manner to be accepted by others and to avoid fights!
7. Sensitivity to loud noises – I cannot listen to them anymore; These people will never understand how their words hurt me!

Case Of Autism Spectrum Disorder:

A case of autism spectrum disorder in a boy of 9 years living in Gujarat. The child was brought to the clinic on 26/03/2022 and presented with the following syndrome: –

• Extreme hyperactivity and restlessness.
• The child was constantly running out of the clinic and had to be restrained by the parents. He was jumping continuously on the couch of the waiting room. The child tried to open the window of the clinic which is on the 6^th floor and had to be stopped by the father.
• He made all sorts of loud nonsensical sounds.
• Monosyllabic speech and no sentence formation till the age of 9 years, and, only responded using single word.
• The child had poor eye contact and never looked at the other person while talking especially when the other person was a stranger.
• The child made irrelevant and absurd responses to any questions asked. He made strange facial expressions and queer gestures with his hands as he could not express itself.
• Biting and hitting himself and his parents; the patient tended to claw at his father’s face and pinch his mother whenever agitated. The child even bit the teachers at school.
• The patient used to handle his genitals whenever excited.
• There was a compulsive need to tap the cheeks whenever excited.
• Involuntary evacuations of stool and urine; child could not express the need to go to the toilet; bedwetting every night.
• The patient could not be taught words as he used to forget every word that the parents and teachers used to teach him.

Conflict In This Case Of Autism

The patient belonged to a very influential family. The parents had a huge social circle and attended a lot of parties every weekend. There were a lot of arguments between the parents daily. 

The mother was a very timid woman, and the father was extremely aggressive. The father of the child had temper issues. Even at the clinic he was constantly shouting at the patient whenever he tried to escape from the clinic or jump on the couch.

The father threatened the child by showing him a hand gesture as if to slap him. Whenever there were tussles between the couple the husband used to break valuable things at home in a fit of rage.

The mother of the child had a habit of collecting fine art works which the father used to break whenever he was agitated at her. The mother had a history of spontaneous miscarriage in her previous pregnancy, and she was afraid about the future course of events of the current pregnancy as she did not want to lose the child at any cost. There was a constant fear of miscarriage throughout the pregnancy. She developed an irrational fear of socializing because she felt that someone had cursed her child in her previous pregnancy because of which she lost her baby suddenly.

When I inquired further, she said that she completely isolated herself from any parties and get-togethers as she was suspicious of the fact that she had been cursed by someone in her group because of which she suffered the loss of her previous child. 

In the previous pregnancy the couple did a lot of socializing and as per the mother, someone in their friend circle only cursed the baby as everyone was jealous of their social status. The mother felt that she might lose this child also because of the curse that had been cast on her.

The mother was diagnosed with placenta previa in the 20^th week ultrasound because of which she was put on bed rest and was advised to have a caesarean section. There was a big fight between the parents and the mother started spotting in the 9^th month when she had to be rushed to the hospital for delivery. The heartbeat of the child was waning, and the mother’s amniotic sac was not breaking which made delivery difficult.

Placenta previa is a problem during pregnancy when the placenta completely or partially covers the opening of the uterus (cervix). The placenta is an organ that develops inside the uterus during pregnancy. It works to provide oxygen and nutrition to the baby and to remove waste. The placenta connects to your baby through the umbilical cord. Typically, the placenta is attached to the top or side of the inner wall of the uterus. This results in some portions of the placental tissue covering the cervix. It can result in bleeding during the pregnancy. In such a case the baby is delivered by caesarean section (C-Section).

This symbolized a reluctance to give birth to the child in the mother as the body closed the cervical opening and the amniotic sac did not break (ALL THESE CHANGES ARE NOT CHANCE OCCURANCES AND HAVE THEIR OWN SIGNIFICANT VALUE FOR TREATMENT OF AUTISTIC CHILDREN)

MY UNDERSTANDING OF THE CASE:

                “Our parents are genetic engineers. Their response to the world becomes their children’s response to the world.” – BRUCE LIPTON – THE BIOLOGY OF BELIEF

In this case the mother’s perception of being cut off from society to safeguard herself became the pathological expression of the child.

The mother had a faulty perception that her baby got aborted because she had been cursed by someone in her group. As a result of which she stopped socializing and completely shut herself up in her house fearing that the curse would fall on the present foetus and may again lead to an abortion. 

The constant fear of losing the baby because she and her baby had been cursed, made the lady totally insecure and fearful. She did not want to have another abortion at any cost and was very apprehensive about the future course of events regarding the pregnancy. 

Placenta previa was the body’s reaction to the fear and insecurity in which the body created a pathology that helped her to seclude from society and rest at home. As the lady was so much caught in her apprehension the body created a barrier preventing natural birth and the amniotic sac did not break when it should have broken.

The fact that the lady started isolating herself because of the perception that she had been cursed made her pass a signal to the child that there is threat from outside and it is safer to seclude oneself (THE LACK OF SOCIAL INTERACTION IN THE MOTHER LED TO A DISEASE STATE IN WHICH THE CHILD STOPPED SOCIAL INTERRACTION COMPLETELY). The body went into a delirious state as the placenta blocked the birth canal, and the amniotic sac did not break – unintelligent response of vital force (always protective as per individual thought process of the pregnant mother).

The rubric considered in this case was DELIRIUM, WRONGS OF IMAGINED and the indicated medicine was prescribed.

NOTE – the medicine is not mentioned as patients often start consuming the same medicine without a thorough homoeopathic understanding of the basis of prescription. Homoeopathy needs individual case examination and there is absolutely no scope for any specific remedies for any disease condition. Homoeopathy treats the man in disease and not the disease in man!

FOLLOW UP:

1^st follow up – 3 months

• Biting at school and home had reduced.
• Hitting parents and himself had reduced.
• Tapping of cheeks and rubbing of genitals had reduced.
• Bedwetting has reduced and the child stands near the toilet when he gets the urge for stool or urine.
• Still restless and hyperactive.

2^nd follow up – 6 months

• Memory is better and picking up new words.
• Tring to express his feelings and communicate.
• Now speak in sentences.
• Answers are more relevant.
• Developed interest in colouring.
• Getting more stars from the school.
• No bedwetting episodes.
• Shrieking has reduced.
• Still restless and hyperactive.

3^rd follow up – 15 months

• Started telling parents when to pass stool.
• Had complete control over stool and urine.
• Started sitting more and restlessness had reduced markedly.
• Better in expressing emotions.
• Sorry if he made a mistake.
• Became more loving.
• Anger is much controlled.
• All jumping and shrieking had gone.
• More meaningful interaction at home and school.
• Better responding to commands from parents and teachers.

How The Autistic Child Should Improve – Direction Of Cure:

• Violence should decrease first – temper tantrums must reduce, biting or hitting must reduce.
• Balancing and walking on toes should be reduced.
• Imitation and repetition must be reduced.
• Restlessness and hyperactivity must be reduced later.
• These emotions which are excessive and out of control should go away – e.g. hugging and kissing strangers.
• Later the eye contact starts (integration process begins).
• Communication becomes complete.
• Intellect develops at the end.