Blog - Shilpa Bhouraskar

A Picture Speaks A Thousand Words...

In Homoeopathy we are trained to rely mostly on verbal communication to understand our cases.
But this can really limit our case understanding in some patients who just cannot express easily in words.
One of the most common question in new students is "How to analyse cases when a patient does not talk much"

Well to be frank when I started I was extremely frustrated in such cases.
But over the years I have learned the beauty of exploring a patient's expression through other ways. Today I have realised that every patient expresses in his or her own language. And providing them the opportunity to express in their own way can effectively bridge this gap in case taking.

In this video I have described one such case where the patient is a little boy of 8 who did not speak for the entire time while his mother narrated the problem. It was only towards the very end that he managed to speak for about a minute!
But this was one of the most critical minute of the entire case.
Because he described a picture he drew for me.
This picture was his way of expressing his inner state.
It helped me confirm the final remedy for me.

Pictures are one of the most common way of nonverbal communication in children. However I have used abstract artwork, doodles, colours, music and many other resources in a variety of creative ways when the verbal communication is inadequate.
This is most effective when the patient is not a trained artist and it is a spontaneous expression of his state.
In fact these expressions can sometimes be even more effective than what you get from a loquacious patient after an hour.

The key to case analysis is then all about knowing the remedy picture at that stage of expression.
This is the beauty of expanding our materia medica of remedies to match that expression.

That's what this video blog is all about...

Leave a comment below and let me know your thoughts. I’d love to hear what you think…
What do you do when patients do not talk in your clinic?


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Since u tube is ban in pakistan therefore we cannot see the video however if you upload on dailymotion then it can be possible.

hello sir dr.Sajjad sb. go for unblock youtube there are amny features lying from shilpa bhouraskar
Dr.Arshad Majeed karachi

Lovely case - thanks Shilpa!

Also a great example of the stages, when it comes up from that depth. The VF communicating directly with you, it seems!

Your remark about using music and even dance as an expression of the state reminded me of a time when I took a remedy myself, and some slightly irritating jazzy music in the background instantly transformed itself into something I really enjoyed.

Could make for some interesting provings, though. How to do it?

This is interesting stuff...however one must be careful in interpreting such drawings. A single drawing can be deceiving or confusing. Instead, looking into his drawing copy where he has drawn pictures using his own imagination, can help the homeopath converge into the remedy with better precision.

In fact, in this case, I had Calc Carb in my mind when I went through the mental symptoms that were recorded by you.

Since I practice online, I generally ask parents about the hobbies of their children and the kinds of pictures they draw, if at all.

Thanks for sharing.


Lovely case Shilpa, thankyou

Hi Shilpa,
It was lovely.
What about teaching a course about stage 4?
I do not think that by just reading the books you suggested will be enough.
Some food for thought:))))


Oh, the drawing equipment will be sitting in a very handy place on my table from now on! Thanks Shilpa - what a memorable way to learn about the deeper levels of Calc. I have found it helpful to ask children (and adults) about their dreams and especially focus on dreams experienced within a couple of days before the interview. It is surprising how often the dream maps out the area that most needs attention - as if the sub-conscious understands that the client is making the effort to heal and colludes with the process.

Thank you so much Shilpa! This was very helpful. I'm only starting my second year an haven't yet focussed on families of Rx's. This put it into context for me. I can go back and reread my Materia Medica with much more understanding. Regards, Lise

Well done with this case, I enjoyed watching it and seeing how it worked. Please do give us more information on the stages. Warm regards, Maria

Thank you for sharing this case. I like how you used different methods to confirm your remedy. My daughter doesn't need a psychotherapist anymore, however when she did go, she was asked to create a drawing every time. She has verbal issues and cannot explain herself easily. A picture is worth a thousand words!!

It is better to observe d patient's area of interest through his body language,his face expressions while his parents talking to d doctor. Try to talk to him after exploring his interest, give him space ,call d patient near to u,give a soft touch to him,he will feel encouraged to open his mind slowly

A very interesting case. Thanks for sharing.

Nice analysis with drawing Dr.shilpa

Enjoying all these cases very much. Giving the dose as a triple dose. Do you mean you gave it 3 times in the one day? Julie

Yes the second time I think I gave him in as a triple split dose( three powders in one single day). The first time was on three consecutive days.


What a lovely case, Shilpa!
Very clarifying
Thank u for sharing

Nice representation,especially of stage IV at will level after the Lachesis case, I like the explanation and the way you presented. Nice sharing.

Thank you Shilpa.
I will request you to elaborate the 4 phases of a medicines. and why you concentrated on Phase4.

One of the rubric that comes to my mind is "lack of self confidence"
Fear of death is another one.

You have not mentioned them some how.

What was his thermals, what type of food he liked or was averse.

You did a good job and i appreciate your emphasis on going through the MM, which consider a last court of appeal for a medicine to be selected.

Dr Wequar

Thanks Dr Wequar,
You may consider reading my book - " When your favourite approach does not work" to understand the 4 Stages Template. You can download a complimentary copy from the left side of this blog page.

Your rubrics are correct. And the case was repertorised using many of the common and peculiar rubrics at the first three stages to get to a group of indicated remedies.

However the intention of this blog is sharing the Stage 4 expression of the child through his drawing. These peculiar source words helped me confirmation the prescription from this group of remedies.

I really enjoyed listening to this case and the way it was managed, drawing seems to be helpful in throwing out hided emotions, the inner state. I used it rarely in my clinic, not always succefully, but enough to highlight and confirm a remedy several times. I think it is useful as some other technics, when it comes to acts with "silent" people, like observation of the body language, tone of voice( if he speaks), physical appearance, relation with music, activities and the noticing of the companion which likely happens to be a close parent

Thanks again shilpa
I appreciate your insight very much. For children it can be difficult to express at this level verbally so observing their expressiveness in other areas opens them to us.
I wondered if you could explain a bit more how you evaluate a patient's sensitivity for determining potency

Thanks Jeannie.
I have created a blog on potency selection at different stages -
Here is the link

I have really enjoyed this Shilpa, and it is very helpful.
I have a followup case of a teenager I have not done wellwith tomorrow, and was thinking of opther ways that I could connect and help my patient to connect, that would allow the process to move forward with a good remedy selection. Does anyone have advice for taking the case in teenagers?

Thanks Katrina
I just wanted to respond to your last question on casetaking in teenagers.
Probably the best place to ask this question is the QuestConnect Discussion forum.
You will get a lot of insight from experienced and new practitioners there.
Hope that helps

Yes, of course, thankyou Shilpa, i will.

Thank you Shilpa,
When a patient doesnt want to talk about themselves or their health then I just ask them to relax and that we can talk about something else...anything else. I will ask them about their pets or their children...about anything at all until I feel them relaxing. Quite often I can steer them back to the reason they have come to see me, but even if I cant the general banter can often be very revealing and help guide me to a remedy.
I do ask children to draw for me but have never thought to ask an adult.