Monomania can be defined as, ‘insanity in relation to a single idea or subject with an unreasonable pursuit of one idea.’ Within the field of mental health this singular definition has been superceded to incorporate further mind related issues such as:-
Idee Fixe which is described as a fixation with an overvalued idea, for example, remaining thin in people with anorexia nervosa.
Kleptomania which is the ‘unhealthy’ obsession with specific objects resulting in hoarding and possible stealing.
Paranoia with delusions of persecution for example.
The above definition will form the basis for describing the possible state of mind of those patients requiring one of the 12 remedies listed within Kent’s repertory under the mind, monomania rubric.
The aconite patient’s mind is in shock, with emotions so violent they can experience panic attacks in almost every situation. It can be argued that they are in fight or flight mind state with physical symptoms supporting this such as increased heart rate and adrenaline release, hence the heightened mind state in which they find themselves experiencing. They are fixated with ideas of their death and in particular their own death sometimes being predicted and the feeling of clairvoyance around this. As a result their mind is heightened in a state of awareness to the point of restlessness and fear of such a high level that they are nervous in all aspects of day to day activities. Crossing the road, crowds, the future are all areas in which the patient’s mind have anxieties and the terror that can be experienced as a result can cause them to fear to leave their house or place of perceived safety. Therefore, the Idee Fixe symptom relating to the patient’s idea of danger can be applied.
The Thuja mind state is one of low self worth and being closed to the outside world. The monomania experienced could be as a result of creating a world that they feel able to control or has been ‘manufactured,’ in their mind, in response to possible abuse of delusion of neglect in their life. Their external appearance to the world and self-presentation within it is paramount to their self survival, masking the true insecurities they hold within, gaining them the reputation of the ‘great masquerader’. Internally, they have fixed ideas of fragility and hold the belief that they could break easily. Appearing confused to the outside world due to persistent thoughts and a number of delusions such as something alive in their abdomen or indeed their soul feeling separate from their body. The latter possibly reflecting their separation from the world in which they live due to the mask they are mentally wearing. Here one can see the paranoia area of monomania as an outward symptom with elements of idée fixe being evident.
Gibson, accurately describes the silicea patient and remedy as ‘a remedy of depth for the over worked individual whose nervous resistance is used up.’ As a result the patient’s mind can become depressed, fearful and a lack of self confidence can develop. This inner conflict of confidence can appear as obstinacy or timidity, requiring the need for positive reinforcement of the fixed image they created for themselves and a concern for what others think of them; however, this again has be to be within a specific way that they have mentally fixed. If placed in a position where this idea could be challenged or indeed lost, they can experience high levels of anxiety as their core survival can be based on the image being protected and upheld. It can be argued that the image they hold as a fixation is one of being conditioned in their early lives to be accepted and the importance of this, when, as Gibson described, their nervous resistance is depleted, is extremely high for their mental survival, thus their idée fixe of self image becomes evident.
The Camphor mind state is one of extreme anxiety and mania, resulting in the overstimulation of the senses, imagination and heightened state of delusion. Their mind can become extremely over active with physical and mental restlessness appearing. The patient can become fixated with paranoid delusions during the night time affecting them in number of ways. For example, a fixation about reality and non-reality and the fine line this can have within a fragile mind state. They can experience delusions about their existence and relationship to the reality of the physical world and spiritual realms. A sense of loss of their physical sense can also be experienced, thus feeding the fixation of what is reality, for example Allen, illustrates this mania state in his description of a patient’s experience, ‘The sight increased my despair, all lay quiet with the clear stars looking down. I could not bear it. The sense of touch was gone and my eyes protruded from their sockets’. One can see by the description the mind is clearly overactive and every aspect of their imagination is heightened by a continued strain of thoughts that cannot be fully controlled at that time, thus exacerbating their anxieties and the vicious cycle of obsession, manic delusions and paranoia continues.
Carbo Veg (Carb-v)
The theme of carbo veg is one of lack of vitality and sluggishness. The mind state is affected in a number of ways, including the loss of memory usually as a result of circulation being impaired. The mind can be slow to react in all aspects of thought, response and comprehension; however, it is here the manifestation of monomania can appear. Through the patient having such a low vitality in the thought processes, they can experience fixed ideas within a hypochondria category. For example, a patient may become obsessed about a specific food that they have heard is bad for them, and due to the low vitality within their mind to challenge it, they will remain fixed to that idea without any flexibility, ignoring or dismissing any other point of view or changing their belief. However, the Carbo Veg mind state can be one of high vitality until this is challenged by shock, illness or disease, when suddenly vitality is lost and the sluggishness becomes evident. The high vitality patient can become obsessed by their work, sometimes, working continuously until their vitality gives way and the more traditional mind picture becomes apparent. Here another aspect of monomania can be found.
Helleborus Niger (Hell)
The patient’s mind state is one of sensory imperfection where the hearing, seeing and other senses can be impaired. They have a slowness about their mind state that results in their inability to think, portraying as dull and stupid. For example, ‘being unable to memorise anything from what they have just read to remembering what they are intending to say’. However, it is here a possible monomania symptom becomes apparent. Although not necessarily remembering what they have just read in word form, their imagination visualises what they may have read about in pictures and they can become fixed and obsessive about such images. They can be highly susceptible to external influences for example, obsessing about things they have been taught to imagine and a strange rare and peculiar symptom of the mind state is one of belief of committing a sin which can impact on their mind within the monomania definition.
Nux Moschata (Nux-m)
It is here with Nux Moschata that monomania could be more as a result of memory than delusion. The mind state of this patient is one associated with memory loss with ‘thoughts suddenly vanish, when talking, reading or writing.’ The task being undertaken may be interrupted and the patient may redo the task, forgetting that it was started or indeed at what place they left the task when the interruption occurred. In essence the actions of this mind state are automatic. There is a tendency for clairvoyance and a dreamy like state throughout the mind of this patient; with some areas of inappropriate response to situations such as laughing, mockery or indeed talking to themselves loudly. A sense of duality is present where they can think they have two heads or are two different people. Here it is clear that the sense of confusion is evident and how monomania can manifest itself.
The patient may have experienced a trauma to their emotions such as disappointed love/ grief which, left to manifest could result in a mental state impacting on their day to day life. There is an element of inner conflict where they place high ideals and expectations on themselves that they strive to make a reality. A level of perfection runs through the mind state and this can result in further disappointment if the perfection is not met. They can become obsessive around food as this, they feel is an area they can control resulting in anorexia or bulimia. They can become obsessive about their health with symptoms of hypochondria focussing on both imaginary and real symptoms. It is important to note that such obsessions can rapidly change to its polar opposite as emotional extremes are key elements of this remedy’s mind state.
The stramonium mind state can be mainly attributed to terror and violence. This can be in the form of a violent turmoil within the mental state of the patient affecting the minds ability to function well. They can have a number of fears and anxieties exacerbating the violent delusion and hallucinations they can experience, including the obsession about their body and appearance for example, feeling tall, limbs not belonging to them or, ‘one half of their body cut off.’ They can have an obsessive preoccupation with the dark, imagining phantoms and waking up screaming in fear and these can continue whilst awake with hallucinations that appear terrifying to them such as snakes, cats and dogs for example. Here the monomania symptom of paranoia is evident.
The sulphur patient could present with the monomania symptom of
Kleptomania in particular with elements of idée fixe within the practice setting. Known for their delusion that ‘old rags are beautiful things,’ mainly relating to their belief of all items, whatever condition having high worth within their life it is clear to see how the patient and why the remedy is included in the monomania rubric. Hering described this patient as ‘the ragged philosopher’ and it is within this description one can begin to see the idée fixe symptom occurring. The patient may become fixed on their own ideas as they believe they have something to offer to the world with grandiose delusions of their contribution to society and opinions. However, fearing humiliation the ideas may not become publically known or shared, but their belief that their ideas are great are still high within their delusional state and everything will be kept for prosperity.
The pulsatilla patient has a paranoia associated with feeling forsaken or abandoned. They become obsessive about company and will utilise their manipulative skills to ensure they receive the attention they require to mentally survive. They can be fastidious whilst carrying out tasks, paying meticulous attention to detail throughout which can become obsessive in nature; however, it is mainly their need for company that affects their mental state within the rubric of monomania and consolation is sought by the pulsatilla patient within their relationships. The pulsatilla patient are themselves affectionate and sympathetic; however, it has been noted that the patient within this remedy picture gives to receive. Possibly due to a number of fears they hold including the dark they can become extremely emotional if they feel they are about to be abandoned or not receiving the attention they feel they require. At a deeper chronic pulsatilla level they can become dogmatic and have obsessions such as those within religious belief systems thus feeding the monomania symptomology.
Anantherum Muricatum (Anan)
The patient within this remedy picture is sad and restless with a fear of death and the future. They are scared of society and will seek opportunities for solitude. In order to take some control over their mental state, they become set in routines and seek out the opportunities to go to the same places and doing the same things. They can come from a stand point of jealousy and a lack of confidence. Their fixed ideas about routine can become obsessive as they feel able to control their environment thus securing the future they so badly fear. Interestingly, although the patient would seek obscurity, there is a strange rare and peculiar sub rubric of mind. monomania, to appear in a public place in a grotesque manner. However, it could be said that this fixation is related to the delusion of not wishing to see or hear anything; therefore the appearing in public in such a manner will ensure they are left alone by members of the public. This could also be due to the mental symptom of mood changes such as a sensation of drunkenness, ‘foolishness and absurd complacency.’
A Gentle miracle post by David