Saturday, March 26, 2011

A Meditation on Massimo Mangialavori

“A complex system presents properties which amount to more than simply the sum of its component parts…a complex system can be composed of only a few elements, but the interaction of components on one scale can lead to complex global behaviours on a larger scale that in general cannot be deduced from knowledge of the individual components.”
Paolo Bellavite and Andrea Signorini, The Emerging Science of Homeopathy: Complexity, Biodynamics and Nanopharmacology, 2002

Massimo Mangialavori is a soft spoken man, yet is very clear about what he thinks. He is a complex system. The components of the seminar I recently attended being like a hologram – each part reflected the whole: his whole system was illustrated thru 2 cases that held everything together (running thru the case, if you will). If you intersected at any point you saw in one part his whole Self. This lovely man was represented in his approach to case taking or, for the purposes of teaching us in the seminar, how he presented his 2 cases as paper cases (well, actually written powerpoints)…consciously not as video cases. His whole Self was captured with his philosophical discussion on historical healing traditions from Western to Asian and Shamanistic ones in between. His whole Self was made evident thru all the facets of what he discussed, from the remedy to his thoughts on different aspects of homeopathy.

A mission-like statement from Massimo’s website:

“I hold it to be true that the story of medicine is begun by man, each and every time that a patient seeks for a remedy: in something, in someone, in something suggested by someone. Yet this dynamic interaction expresses itself therapeutically in a way which we are still far from understanding in its entirety, and which has to do with Medicine - all of it.” Dr. M. Mangialavori

He also can use the F word (very appropriately and only once) and is lively and animated, but not hurried…Um, more of a man with a quiet determination or, more to the point, with integrity. Yet, you totally experience him as being flexible and open enough to see that his experiences are just that, his own experiences.

Massimo referred to Hahnemann’s beautiful words by way of illustrating his appreciation of our founder and to discuss health and disease as an underlying theme of his lecture. I would say he undoubtedly is living his higher purpose:

“In the healthy human state, the spirit-like life force (autocracy) that enlivens the material organism as dynamis, governs without restriction and keeps all parts of the organism in admirable, harmonious, vital operation, as regards both feelings and functions, so that our indwelling, rational spirit can freely avail itself of this living, healthy instrument for the higher purposes of our existence.” Aphorism 9, Organon, 6th Ed., S. Hahnemann

It was a real privilege to see him in a seminar. It was my first time and I was very impressed indeed. I sat right up front (due to wearing the wrong glasses that day). It was wonderful as I felt the Vib and not just watched; it was as if he spoke to me! There were about 100 - 150 people (who knows as they were behind me! lol). I was one of the first 10 to sign up (on FB, so, maybe in top 50) as he was my first love in Links – which really helped me to get to know the names of the avant-garde in our field. Sort of like the Polycrests…they get presecribed and with more usage they are the one’s that we get to know. In this case, it is warranted as they, like Massimo, are not names but, they are human’s having experiences that have evolved with careful thought and intentions going behind their cases. Why are they presenting them publicly in the first place? They are advancing Homeopathy…MM for sure and our practice in order to ensure that we are all going along with them on a journey down the road to the best that we can be. These are the Stage 10 of the Silver Series people, and it’s in seminars where they shine.

It was a most enjoyable seminar in the same way that I enjoyed Jan Scholten before and how I experience my wonderful Master Clinician Course (HMC) with Louis Klein. Yet, it was completely different from anything I have experienced before. He was not teaching Materia Medica and we did not watch cases as we do with the other evolved teachers. He was worlds apart from Farokh Master, that was last May. Different from Rajan Sankaran and Divya Chhabra (who I also have seen personally here in my hometown a few years back*) and who, no doubt, are “big names”. Master, a “big name”, I would say maintains the status quo, but I have a place in my heart for his love of detail – I feel I need him on my bookshelves just as I need to read Sankaran but don’t practice the Sensation Method.

* - Sorry to brag, but we here in Toronto just have to step out our door these days and it’s raining world class Homeopaths – Paul Herscu and Peter Fraser are here next, both in April. We don’t say “April showers” for nothing!

This seminar was about Massimo’s own journey to get to his Method of Complexity and then how it works in cases – basis of the books Praxis Vol 1 and Vol 2. He signed these so lovingly as everyone lined up to chat with him. It seemed to me that he was in a Zen like state (even with the use of the F word in the mix). Did I mention he gave the finger in a story he told, sort of as though it were a koan. It was about an allopathic doctor who was going to sue him when he hung up his shingle in a small Italian town he once resided in. When he described for us how he responded in his thoughts to this threat he gestured using the middle finger of his hand, oh my! Funny guy but, to be clear, not comical. Sort of like the Buddhist monks I’ve heard speak on life’s lessons.

The seminar was in fact like getting on a tour bus but with Massimo Mangialavori as the guide. He took us on a trip back in time and then returned us to our present place in time and space in the Land of Homeopathy. I love organized tours as long as there is still a sense of adventure. We certainly did go exploring. He can field questions and give his views without losing the thread of the whole lecture he was giving. I recognize it might not have been everyone’s cup of tea, but, for me, it was great! I love this type of off the wall stuff – but, it could have been a situation where you were either on the bus or not…I sensed that there were some wanting off the bus, but there were no bus stops to disembark as Massimo was invited to present this seminar and had no idea that some were only prepared for the “usual” type of seminar – MM with cases and smatterings of philosophy and ideas about practice as side bars, not the other way around.

I will add that I feel there is no such thing as a typical seminar as all great homeopathic teachers have a philosophical framework that is applicable to practice. In a good seminar and in their writings these evolved homeopaths share this as they teach us MM. Their philosophy isn’t airy fairy…but, rather, it’s something that you can sink your teeth into, bite it off, chew it and then swallow and digest it to actually gain nutrients from it to create energy that is forever growing and useful to you in your practice. I always end up chewing with my mouth open as I bite off more than I can chew when I’m excited…but, I also, go back to thinking of Buddhist monks that chew their food 50 times per mouthful. In this way, I try to remember that it is all good – there will be plenty of food for thought for years to come, so no need to panic and gulp down the mouthfuls all at once.

In my opinion, it is a luxury to take time out of our busy schedules to have a holiday; I felt like a tourist in my own city with Massimo. This journey was one where you got to step back in time, in life really, and take a breather to view the big picture. To reflect on the historical context of homeopathy – we were guided through its evolution. His explorations on his journey led him to the unique place he holds in our modern homeopathic history. Needless to say, his books are now on the top of my reading list. The contents of Praxis and Preface and Introduction can be found here (I haven’t peeped as still savoring my tour with Massimo):

Any sensitive, creative person that has an inquiring mind, I believe, would actually end up somewhere close to where Massimo (Louis, Rajan or any other “big name”) has on the Homeopathic map. Massimo did use the description of a terrain and a map as an analogy in his description of MM - of remedies and how we see them in the state of patients.[1]

What I see as common with the homeopaths that have shifted Homeopathy from the earlier times of Kent, Herring and, of course, Hahnemann, is that they, like their predecessors, had to step it up so as to make a quantum leap. They had to make advances in their practice that matched, as it were, the patients and their ailments that were “advancing” with the times. Even in Hahnemann’s lifetime he saw this when comparing the conditions in small communities in Germany to those with his patients in Paris. Instead of doing this in relation to allopathy or conventional science/medicine the homeopathic vanguard of modern times had to do this in relation to other homeopaths who still steadfastly believed that Hahnemann and a few others had mined the territory fully.[2]

Without too much research but upon a quick recall of what I know, I would say George Vithoulkas was the first to do this inadvertently. Maybe some others, but for arguments sake do just go along with me, okay? Next, we got the likes of the above named homeopaths and many others…like Alize Timmerman, Frans Vermeulen, Harry van der Zee, Jeremy Sherr, Jonathan Shore, Nancy Herrick, Paul Herscu….who else is there?? Others that we can think of, Misha Norland, who else? Irene Schlingensiepen-Brysch and Melissa Assilem. Others, at any rate, who are advanced yet have a strong basis in our foundation: hip and happening really, like…jazz musicians that use the musical scale to play some really innovative jazz.

I would recommend this lecture if the opportunity arises for you to attend – he has given this lecture before (seems designed to go along with the publication of Praxis) and we were lucky to have him at our doorstep to present his method – I even drank a glass of wine with him and his son at a social on the Saturday night! (no talk of homeopathy though - we talked about skating as a pastime in Canada). In this 2 day lecture you will get MM of a great remedy, but it will be to illustrate and tell the story of Massimo’s journey of how he both makes the MM of a remedy and how he forms Families – not mere classification (notice the suspense I am creating – “What remedy, damn it, did he do?” you ask. “Oh, you’ll see….” ).

This he argues is what is homeopathically useful, as all the other progressive homeopaths do as well: families/systemically grouping based on experience with the remedies in clinic. He gave the example of conventional botanical classification. So what? Massimo says: we can classify, as does science, but really it is just an innate human trait to classify. The botanical world is classified, but this is somewhat useless to us as there are shifts based on reorganization that continuously happens. In ancient times plants, for instance, were classified by flower colour.

I should mention here that I am interested in what Stephanie Nile’s speaks to in her book, The Structure of the Plant Kingdom. Also, we do know that Scholten’s plant Families based on sciences classification are different than Sankarans, but there is order…and, not just a chaotic or random system (just as his findings with the Periodic Table paralleled the actual scientific classification). From what I can see in the huge amount of exerts on the Narayana website of the Nile's book, she is part of the next generation that Massimo talked about. He declared that the next generation of homeopaths will take over the work of himself and others like Scholten and Sankaran (to use what they have discovered and then move on with the job of classification re- Families and to cross Kingdoms). See excerpts here for those so inclined to take a detour at this time:

There was so much spoken about, very complex, haha…but, quite simple at the same time. We were continuously all brought back on the tour bus to the town square to get our bearings. Everything was grounded in the reality of the whole point of homeopathy: to cure patients of their ailments/imbalances. For me, in the town square (breaks) there was time to sip tea and to digest what was said – it was interesting though that the participants did not really chat on the contents of what Massimo said – it was either a case of being in a state of shock or there being lots of inner reflection going on. It was hard to gage what was the reaction of the crowd, again it was a situation of my lack of the correct prescription glasses that contributed to what was happening for me!

Another facet of the seminar was the idea of what substances to use as remedies in the first place. According to Massimo there were 3 things of interest as the basis of why we should bring into homeopathic usage any substance in the first place. They were: its use to humans, the substance’s source characteristics, and also the myths and lore of the substance. The clinical usage, however, is what Massimo finds to be even more important then the proving results of a substance. He spoke to this and put provings in the context of Hahnemann and others, including medical practitioners and healers from European and non-European cultures. His view boils down to this on Provings:

“With the universe of knowledge about the substances, it’s limiting to exclude all the information beyond that which arises from the homeopathic proving.”

He moved towards discussing and illustrating that remedies and their Family classification are only useful from what we see in our patients. So our MM and Reps are useful only if we can get a picture of a remedy based on patients cured with the remedy in question. He is working on his own MM based on what he preaches, cases – 10,000 he has in his data bank (This is what I heard, my glasses don’t effect my hearing…I just wanna know if all of these were his patients over the last 30 yrs, or included are cases of his students and colleagues as well?)!

The remedies are grouped in Families, as most of you would know if you have read his works, unlike myself. He groups around themes that are seen in all the clinical cases that he personally has seen in his 30 years of practice. I do, nonetheless, know this from the great seminar titles/emails I get that Betty Wood sends out – Sigh, I would love to have been attending those over the last few years.

Quick aside – I’ve noticed all the “big names” got underway 30 years ago. Anyways, this seminar had as its foundation or running thru the case! an exploration of 2 cases of Oleum animals. Ahhh, the remedy finally revealed, and what a remedy, folks. The cases were amazing. I wonder if they are in Praxis – will have to wait till my books arrive from Narayana.

Anyways, how he came up with the 3 themes/parts of the remedy were from these and a number of other patients that he saw who were cured with the remedy. A cure, as he states, is when after at least 5 years follow-up there is no more pathology – at a deep level, so not just a superficial cure. A great discussion was had on the merits of Hahnemann’s beautiful aim of cure, Aphorism 9 as referred to above.

He also stated something that some would consider contentious:

“We are looking to treat the patients, their deepest anguish. We have to look at what is not treatable and what is curable in our patient – when we think we can cure that is our delusion. It is bullshit – the most that we can do is to help our patient to be compensated successfully of their state. We can help our patient to better cope and to compensate [their] situation, but whenever in life the difficult situation arises….they always break in the same place [like a crystal vase]…if we treat with a remedy and are helped with deep treatment then they can deal faster and better in the future [with what is their issue]…Best we can do is help with DNA problems, but we can’t change DNA.”

I recall that the main teacher during my initial study of homeopathy gave us lots of Massimo stories. Even though I never finished with the school where it all began for me, it was, nevertheless, my foundation to launch off into the world of Homeopathy. I am still grateful for the awareness that I got of the wider world of homeopathy, the global picture of it. We got stories galore and that is how I best learn, so that school was a good match in that way for me. The Massimo stories were always the best. I must say I had the impression that his presence would be stronger in more of an eccentric way, but this was not the case at all – he’s a philosophical and artsy dude really, but really meticulous and into exacting science of Homeopathy as well. Also, a computer nut who is all about keeping and sorting the vast amounts of data that he plays with to make useful summaries or classifications for us all. I am Left leaning (politically as well) and so, the doubt is too great to move to doing this, but our guys and gals that are centrally located on the periodic table do this important work for us;-) Massimo told us that each morning he spends about 30 or 40 minutes reading over past cases in relation to new Families he comes up with and to compare with his current cases.

The themes of the remedy were given initially to show us that his themes are precise or small but broad as well.
They were:
Over trying, frustrated as know can’t succeed to be accepted by father due to own inadequacies
Feel deformed/ugly
He used the term as summary, “professional loser” for this remedy. Not that he felt the patients were that – you sensed that he really felt compassion for them in their anguish.

But, what Massimo was telling us was that with the first theme, there are huge number of remedies, right. As with the other themes. Withdrawal is there in lots of other remedies and Drug Family remedies – not all, but many, right? Well, his point is that only with this remedy do you have the constellation of these 3 themes together. And with each case, patient, you see that is Oleum animales you will see the emphasis differently within these 3 themes.

The first case, a 16 year old boy, the second a 45 year woman. Similarities yes, but wonderful expressions (sad and with pathology, granted) of Oleum animales. We also got a DD of a Carbo-veg case and in this 41 yr old woman we could see the commonalities, but once you read over and felt the case we broke off into small groups. We looked at aspects of the cases/sxs and you could distinctly see differences even though there was so much in common on the M/E and physical levels.

The remedy we did is made from Stag’s horn and in line with the criteria of Massimo since it was used as far back as 3000 years ago by the Egyptians and has been used in other forms throughout human history. Chinese medicine for instance: my grandmother who lived in a healthy and vibrant manner right till she was 101 used this ground up in a Chinese herbal concoction that she regularly took. So did my grandfather and he lived until 87…and was vital up to the end too. Admittedly, my grandmother used more tiger bone ground up…totally illegal and not a renewable source like antler horn.

Massimo’s work on the source was cool – the antlers are regenerated each season (we saw shots of the growth rate of the full antler sets – amazing)…Also, about the symbolic fight to mate of the stag, the head is where all the energy and blood go to grow the antlers which are symbolic of male power. The masculinity here is the issue of falling down, though. It should be noted that the horns are made stronger when the stag’s fight, they need to lock horns to actually make more vascular tissue. In terms of falling down, the horns fall down to the ground at season’s end – so, the remedy is not about the erect penis. It is a flaccid penis. The ex-phallus of the animal. Let’s see what else is in my notes: oh yes, a phallus is a symbol of power and so, the antlers are what remain of the power, they are not powerful. Physically the bones, structure of patients are weak.

This is what is seen in the Family of volatile carbons (Clark’s early classification was good said Massimo for this and good DDs) and in this remedy in particular you see in the slow movement, the chill (1/2 of body or parts and with numbness or loss of sensation of parts – physical expression of the withdrawal from world, as is the constant long sleep of the patients – 15 hrs and no dreaming and no sense of being rested when wake). Note- there is more affinity with this group and with the oils, like Oleum jecoris than with other horned animals, such as deer or cows. I did share with him from Louis Klein’s Clinical Focus Guide the write up on this remedy and he was keen to have and read. Massimo told me that he always meant to look at Louis Klein’s work but just hadn’t had time before. Broad minded, for sure, would be a theme in his remedy!

The theme of ugly/deformed was experienced by the 16 year old as having the sensation of an enlarged head/seeing himself as a monster as if he was Frankenstein. In the remedy one often sees head deformity of some sort – as Massimo did in nearly all of his cases with exception of just one, if I remember correctly. The woman had a situation where her jaw could get stuck always in the open position. For her whole life, she never allowed herself to laugh or even smile so as not have her jaw end up unhinged. She also was extremely embarrassed (mortified) of her bad teeth which no one would fix. And, the parent(s) in the remedy/cases of Massimo always are not emotionally available or even physically present that much – so, it takes a drastic health issue really to alert them that their child needs care, even basic medical attention.

In the boy’s case, he had acne that was not really bad, but because his father was scarred from acne he was actually afraid of this for himself – but, the CC of the father was the boy’s slow learning and psychological problems – very slow (all patients have extremely slow movements) and withdrawn (as in 1st theme). He was finally getting help as he was failing at school and the father was at wits end about this as an educator. The boy was more pronounced, clearly obvious in this as opposed to the case of the female case – she was less compensated is what Massimo pointed out. At this point, the tour bus took a great detour and we had a nice discussion on compensation as a concept. At this point Massimo gave his view of health and disease and what is to be treated with homeopathy.

Last tidbit on Oleum animale that is super neat but relevant is that the substance was originally used in modern times by chemist/doctor, Johann Conrad Dippel of Dippel’s oil fame...made from the substance – the stag’s horn. It was in the employ of the Frankenstein family and in their Castle – yes, the basis of the movies and was the place and this inventor, made into mad scientist of Mary Shelley’s gothic novel. And here in the case, totally played out in the life of the 16 year old boy. His father actually showed him the funny version of the film with Mel Brooks in hopes of having him overcome his fears about Frankenstein, but to no avail as he ended up finding and watching the serious version with Robert De Niro. He resonated with the monster in it and ended up feeling even more sad/depressed and isolated, more of a monster himself. It was one of those homeopathic moments – yet, another Massimo story to add to our canon!
(More juicy stuff:

So, to finish up my meditation on Massimo I’ll give this to you word for word in honour of him:

“On the concept of simillimum…can be seen in many different ways…according to your expectations. If we are homeopathic doctors means we use homeopathic remedies…we all have different expectations, ie – in the child (16 year old boy) – decent level of treatment would be to not have difficulty with skin and discharges – for the lady would be the backache…could have considered a lot of other remediess – and the remedies would have helped and you would be satisfied and they happy…what your expectation is the key there!!

Define Disease –if start from what Hahnemann said…the aim of good therapy is to have patient achieve their highest purpose of their existence…means you should be able to help person in their evolution…so with the lady not only the back and ear – but to have a more satisfactory life – to be more creative to blow out in her office, to recognize she could have a better life.

You could not expect to come out from school and do this at beginning – I think more then sufficient to help little by little the patient…honest to help the state of the patient – I think the state is the whole of the patient.

When cholera of Europe with Hahnemann – I do best that I can and I am honest, this is better then they take antibiotics…
If you have more symptomatic approach with the patient - superficial then enough to stop the poor kids [of developing world] not to have such diarrhea. If you can take more time to see them and you are interested to do more. [To do] better then possible – not be intimated by idea that [you may] not find a constitutional remedy at first, just try best…

If you treat acutes with [the] constitutional it should work for a few years [for you] to know it is constitutional…with chronic disease need, [such as]MS, need many years of improvement, with a crisis then know is the constitutional…”

In closing, it was inspiring to hear from this lovely human being in his prime (not like the stag horn, haha) that you can simply be honest in your intentions and start small and evolve in getting to the depth of our patient’s states. Knowing MM in a deep and evolved way, as in his Method of Complexity, is essential – but, together, skill and knowledge can go a long way. I would say that due to his genuine interest in us, those of us in the seminar listening to him, I left feeling good and if there had been “I Love Massimo” t-shirts available for purchase I would have bought one.

This is for you Massimo:

Heaven goes on forever.
Earth endures forever.

There’s a reason heaven and earth go on enduring forever:
Their life isn’t their own
So their life goes on forever.

Hence, in putting himself last
the sage puts himself first,
and in giving himself up
he preserves himself.

If you aren’t free of yourself
How will you ever become yourself?

From the Tao Te Ching (#7), Lao Tzu

[1] As it so happens I presently am reading Louis Klein’s Miasms and Nosodes, so can’t promise a review of Praxis and, hence, why I am not allowing myself to read even excerpts from Narayana’s website…and, incidentally, Klein’s book as well meets my criterion of an evolved teacher/homeopath big time! Thoughts to follow one day…for an actual review see:
NB - the comments posted afterwards are interesting as they address my current fav topic: new methodologies vs. traditional classical homeopathy.

[2] Good example of this adherence to original classical homeopathy in our times is in a Master book from 2008. I own it and love it as a dear little friend. Like an old friend that warms the heart and is there when you need them, but they tenaciously stick to romanticizing your past life together, without acknowledging you have changed as a person and, that maybe, it is time to move on...but, at the same time, who better to reminisce with then those that know you from back in the day?

1 comment:

  1. Dear Laura,

    surfing in internet I just stumbled in your article.
    I'd like to thank you from the deep of my heart for your nice, acute, and professional article.

    Thanks a lot and a big hug
    Massimo Mangialavori