2009 Novembre

C.Q. Curability Quotient

de Dr.Chetna N.Shukla
C.Q. Curability Quotient: The CMS model of C.Q

CMS model = (Chetna Madhukanta Shukla) model

Healthy potentialities that are pointers towards an ability to heal the self

The concept of C.Q
Health is about agreeable sensations and harmonious functioning. This harmony is maintained effortlessly by the Vital force by reacting to a multitude of stimuli in the environment every single moment. The Vital force in health is fighting deranging influences all the time and winning all of the battles. The Vital force in health knows to detect the damaging influence that damages the organism, discard it and repair itself. This is happening within us outside of our awareness. This knowledge to maintain the harmonious functioning, to be one’s therapist and cure oneself is an inherent wisdom inside the human organism. This is exhibited as admirable, harmonious, vital operation, as regards both sensations and functions. These are reflected as the presence of healthy mental attributes. A healthy person is her own best therapist.

The failure to maintain this harmony, the failure to win the fight against deranging influences that damages the organism causes what is called disease. In disease the Vital force is incapable of repairing the organism from the damaging influence and is also incapable of discarding the damaging influence. In disease the inherent capacity to react to stimuli gets injurious and is exhibited in disagreeable sensations, and irregular processes that we call disease. These are reflected as the presence of unhealthy mental attributes. A sick person is not her own best therapist.

But nonetheless the capacity to repair is inherent in all living beings. In health this capacity to repair is efficient and in disease it is inefficient. During the process of recovery/ rearrangement this efficiency gets efficient again after the impetus it receives from the Similimum.

If we can gage the efficiency of this ability to repair in the individual, we can comprehend whether the patient has all the traits working efficiently to restore her organism. These traits collectively contribute to (or define) that “will to get well”. We can define the traits that need to be worked on or fine-tune them to achieve the highest ideal of cure. This ability to cure is termed curability. The measure/score of the same is Curability Quotient ( CQ). The CMS model of CQ is a test to measure the ability to restore one’s self to health; the ability to repair oneself through the ‘mindbody’ unit.

It is a recognized fact that the ‘mindbody’ is a seamless unit. The phenomenon of the mind reflects in the body and that of the body reflect in the mind. Our “mindbody” is connected and directly relays signals to our Repair System (Immune system). The Repair system is known to rely and respond to emotional signals originating in our minds. The direct governance (and the interdependence) of the Repair system by moods, emotions and attributes of the mind is an incontrovertible and a biochemical fact. The efficiency of our repair system is directly de on the governing presence of these mental attributes (moods, emotions, habits, mental traits and tendencies).

Each individual’s ability to repair is 100% in health. This 100% ability is expressed as an assurance that …
“In the healthy condition of man, the spiritual vital force (autocracy), the dynamis that animates the material body (organism), rules with unbounded sway, and retains all parts of the organism in admirable, harmonious, vital operation, as regards both sensations and functions, so that our indwelling, reason gifted mind can employ this living, healthy instrument for the higher purposes of our existence.”

Although curability is innate, the quotient can be cultivated and improved through training of the mind and maximising of these healthy attributes, de-programming and re-programming of certain traits that do not encourage the maintaining of health. These healthy attributes are health potentialities that any individual can maximise and express in her own unique way. These collectively go to form what we call the “will to get well”.

The governing presence of these traits help assess the ‘Curability Quotient’ (The score is not fixed though!) to achieve what both the doctor-patient duo earnestly aspire: the highest Ideal of Cure!

How do I recognize this will to get well/ these healthributes?
Hahnemann says in his Organon (6th edition) in footnote 9 to §16 to the use of the word dynamic/virtual…
§ 16
“Most severe disease may be produced by sufficient disturbance of the vital force through the imagination and also cured by the same means.”

We all believe in this innate knowledge and accept with certainty the truth that all sick people have asked for their sickness. Somewhere deep in their unconscious minds they have the blueprint of the disease condition they want. They select their symptoms to fit, suit and affect the needs of their conflicts. This is done free of their “will” and awareness. The exact form of bodily ailment is chosen by an emotional system that is seeking to save something from its own wreckage and /or seeking some benefit. But despite their welcoming their sickness with open hearts and arms, the sick do not deliberately desire to make a complete wreckage of their organism. Nobody wants to be sick. This is the dichotomy of health.

This “will” collectively (and in isolation) are healthy mental attributes that refer to the capacity of knowing, using, expressing and managing one’s inner world to repair and heal oneself. The soil for the Similimum to work its wonders is inside the recesses of her mind, depending principally on the governing presence of these mental healthy attributes: ‘healthributes’ (healthy+attributes). When this “will” is present the sick do not need the disease anymore (This can also be called the “conversion point’). In this point they are willing to co-operate by taking responsibility, observing obedience, having endurance and knowing exactly their own role in the restoration work of their wreckage. Ever thought why some patient/s having been under the care of the best of Homoeopath do respond and suddenly do well with the same remedy in the same potency given by the first homoeopath? The last one was given at this point of conversion!

These Healthributes are the universally known mental traits of the ability to cope, ability to express our selves, ability to confide, ability to commit to self preservation, and above all the ability to love and many more that I have listed as A to Z in the article further.

What is the practical utility of CQ?
Once we have been able to recognize the presence or the absence of certain ‘healthributes’ we can map out the obstacles in the journey to restoration of health. Once these are defined, we are better equipped in offering assistance and accurate opportunities to the sick (through sensible friendly exhortations, consolatory arguments, serious representations and sensible advice (§224) to modify thought processes/habits etc.) to restore her to health before or after the indicated medicine has been administered.

A patient confronted with these questions (as a questionnaire sheet) grows more awareness about her own role and potential in health and disease. After this point they can get keen to co-operate by taking responsibility, minding one’s mind, observing obedience, having endurance and knowing exactly their own role in the restoration work of their wreckage.

The CQ questionnaire also helps realize the 4th aphorism as a Homoeopath. The questionnaire I use even in patients (Sorry read as people!) who regard themselves as ‘well’. A low score ranging from fair, average and very poor would give us the Susceptibility Quotient (SQ) for disease. It indicates the risk of developing a disease . A poor score without tangible disease (silent disease) calls for management with utmost sensitivity, tact and circumspection.

The Healthributes can be de-learned and re-learned! We can help the sick modify her CQ at any point in her life by assisting her to de-learn and relearn certain traits that have a deranging influence on health. And just as easily as the sick can increase her CQ she can (in health and in disease) also decrease it by embracing certain deranging traits (Footnote 78).

What is the right time to conduct this test?
If you can identify with the way I work (choosing your patients) than the right time is to take this test before deciding to enroll the individual as your patient. But it would be insensitive to tell the patient that their C.Q is low. If one identifies a ‘resistant’, ‘doubtful’ , ‘en passant’ , ‘de’ or a ‘contagion’ patient than what I do is…

1. We cannot force any patient to change; we can only ‘help’ them to change themselves when and if they decide to and in the time they decide to. But we can very tactfully let them know that they are ‘nurturing’ a disease and wait for the time when they decide not to have the disease anymore (for resistant patient)
2. I dissuade them tactfully into starting treatment by giving dietary assistance to the existing medical regime, minor changes in regimen (sleeping habits, habits, exercises) or some home remedies. If they are earnest in continuing treatment with homoeopathy, they come back after having followed the instructions. In some I ask to continue treatment with the previous doctor ( in the ‘en passant’ or ‘doubtful’ patient).
3. For the ones who do not recognize with the concept of exerting their right to choose their patients they can conduct the test when they detect…
• Resistance to recovery despite the Indicated medicine being verified.
• During the course of treatment when the journey to recovery is slow.
• The disease returns again.
• There are some stubborn left over symptoms of the disease under treatment while most have dissipated.

The A to Z Healthributes for assessing the ‘Curability Quotient’ of the sick.
(I have 100 Questions in all to choose from. I present only the prominent ones that I feel may apply to most cultures and countries and to fit the requirements of this article)

Instructions for patients…
1. What you think or feel in any one moment is not the totality of what you are. Therefore read the question carefully, relate it and connect it with your inner self to answer.
2. For any answer you give feel free to make special comment/to give a reason to it.
3. It is not necessary to strictly follow the numbering while answering.
4. Kindly suspend your critical abilities while answering the questions.

Awareness ability of her body-mind symptoms:
1. Am I convinced I have a disease/that I am sick and need help to heal myself? Yes /Maybe/No
2. Am I aware when and how does my sickness get aggravated/ exacerbated?
Yes /Maybe/No

Acceptance ability of her body-mind symptoms:
3. Do I believe that my state of mind contributes to the causing of my sickness and the maintaining of the same? Yes /Maybe/No

Balancing ability of her body-mind symptoms:
4. Do I believe that my perception of suffering (physical/mental) is proportional to the intensity of the sickness? Yes /Maybe/No

Specify: More /Less
5. Am I reasonably tolerant of pain/suffering? Yes /Maybe/No

Connecting ability of her body-mind symptoms:
6. Can I think of any event from my life/from my lifestyle that I feel could have contributed to the origin of the sickness? Yes /Maybe/No
7. Do I trust more the sense of well-being I carry inside me over the laboratory reports that say ‘within normal limits’? Yes /Maybe/No

Confiding ability of her body-mind symptoms:
8. Do I have a confidante? Yes /Maybe/No
9. Does s/he know everything about me, my nature and the nature my sickness? Yes /Maybe/No
10. Whom do I discuss my problems/stress with and Why? (No marks)

Coping ability of her body-mind symptoms:
11. Do I take measures to de stress myself/keep myself in a state of optimum health (go on holidays, take family vacations, read a book, Yoga, Tai-chi etc)? Yes /Maybe/No

Demonstrating ability of her body-mind symptoms:
12. Can I give a mental picture of my sickness? Yes /Maybe/No
(Kindly sketch or write in the attached blank sheet/ you can make use of colors)

Expressing ability of her body-mind symptoms:
13. Do I feel that I can express my inner self clearly? Yes /Maybe/No
14. How can I best express my inner self clearly? Verbally/ Writing/Sketching or any other way? (No marks)

Fear associated with her body-mind symptoms:
15. Do I have fears surrounding my disease? Yes /Maybe/No
16. What are my fears associated with/ surrounding my sickness? (No marks)

God, role of, in her life:
17. Do I believe in the role of Higher Power /All wise preserver of Health (some call it God, whatever name you give) in my life: in health, in disease, and in getting well? Yes /Maybe/No

Hardiness/ Commitment and Heredity role in her life:
18. Will I discuss (and strategize with you) in detail with you if the progress of my recovery is not the way we expected it to be? Yes /Maybe/No
19. Do I believe that it is not necessary for me to get the sickness (or to get the same disease) as it runs in my family (including ancestors)? Yes /Maybe/No

Imagination ability of her body-mind symptoms:
20. Can I imagine that I will be free of the sickness in a stipulated time decided by me mentally? Yes /Maybe/No
21. How do I imagine being free of the sickness as? : Completely free/ With Sequel / Residue symptoms/ etc. (No marks)
22. What would I do after getting well, Imagine? (No marks)

Judgment ability:
23. Am I seeking Homoeopath because I want holistic treatment? Yes /Maybe/No

Knowledge about her body-mind symptoms:
24. * Do I have complete knowledge of the prognosis and outcome of my sickness and yet do not believe in the medical texts/statistics? Yes /Maybe/No
(* Applicable specially to patients from the medical/paramedical fraternity)

Love for self:
25. Do I love myself the way I am (in physical structure, mental make up, etc)? Yes /Maybe/No

Motive of getting well:
26. Is my motive to get treated to enjoy optimum health? Yes /Maybe/No

Noli me tangere (Touch me not):
27. Do I have a history of not tolerating substances/allopathic that is known to be harmless to others? Yes /Maybe/No
(Yes is 3 marks as this person’s is not tolerating damaging chemicals.)

28. Do I do enough for my up keep (Eat in time, Eat good food, Sleep in time, Exercise, Yoga, Take holidays, Play, Pray, Sports, Think good, Meditation, etc)? Yes /Maybe/No

Preserver of her health:
29. Have I taken preventive measures to check my sickness from progressing before meeting you (quit bad habits, change in diet and regimen, start exercise, quit junk food, corrected work/ travel addiction, reduced on partying etc)? Yes /Maybe (Sometimes)/No
30. Will I take adequate precautions to take care that I do not to fall sick again? Yes /Maybe/No
31. Do I believe it is I who is responsible/have contributed to the causing of the disease? Yes /Maybe/No
32. What/How have I contributed to the causing of the sickness? (No marks)

Que Sera Sera (What will be will be):
33.Do I believe that the principle of Que sera sera (what will be will be) does not apply to my sickness and eventuality of my sickness? Yes /Maybe/No

Repressing not (Express) ability:
34. Have I ever-experienced anxiety/fear/depression? Yes /Maybe/No or Never
35. When have I experienced anxiety/fear/depression? (No marks) (*Repressed individuals say “never”)
36. How do I rate my life Perfect/Average/Stress prone or any other quality that I can specify? (No marks) (*Repressed individuals say it is “perfect”)
37. Do I react if someone is offensive/abusive toward me? Yes /Maybe (Sometimes) /No or Never
(* Between the two, Repress and Suppress, the difference is of awareness)

Suppressing not (Express) ability:
38. Do I indulge in gossip? Yes /Maybe (Sometimes)/No or Never
39. Do I at times ask for favors? Yes /Maybe (Sometimes)/No or Never
40. Do I sometimes tell someone off if they are irritating me? Yes /Maybe (Sometimes)/No or Never

Trusting ability about her body-mind symptoms:
41. Will I discuss with you if I am not satisfied with the treatment offered to me in the clinic? Yes /Maybe/No
42. Would I consult a family physician/medically qualified person with whom I would cross check the progress of my recovery? Yes /Maybe/No

Understanding ability of her body-mind symptoms:
43. Do I understand well my sickness, the system of homoeopathy, and my recovery with it? Yes /Maybe/No

44. Do I feel it is I who has to contribute primarily toward my getting well? Yes /Maybe/No

Writing ability to express her body-mind symptoms:
45. Can I express without censor by writing everything I feel to myself? Yes /Maybe/No
46. Can I express without censor by writing everything I feel, and allow someone else to read the same? Yes /Maybe/No

X-ray ability for health:
47. Can I imagine that I will be free of the sickness and any other sickness hereafter? Yes /Maybe/No

Yo-Yo history of previous sickness:
48. Have I suffered from one/any sicknesses that have recurred? Yes /Maybe/No

49. Am I in the good habit of sleeping by 11 p.m; ‘the early to bed and early to rise types’? Yes/Sometimes/No

The Scoring…
Total criteria: 49
Criteria for scoring Yes /Maybe/No: 41
Points for answering a Yes =3; May be/Sometimes= 2; No or Never =1

If ‘Yes’ to all criteria: Be careful/ Faking/ Not serious/ Ideal patient/ Homoeopath/
Perfectly Healthy /Psychologically controlled/Psychologists
If ‘No’ to all criteria: Non serious
If ‘May be’ to all criteria: Mentally unstable/ Confused/Noncommittal

Scores: 104 & above : Excellent
Scores: 103-94 : Very good
Scores: 93-74 : Good
Scores: 73-64 : Fair
Scores: 63-54 : Average/ so-so
Scores: 53- 42 : Very poor

Remember this …
1. All questions need not be asked to a patient. Ask only the one’s applicable decided after the individualizing examination or during the initial interview.

2. The scores must be interpreted with reference to the totality of the case. It has to be a ‘right brained’ (intuitive and holistic) synthesis of the scores. We should not be ‘left brained’ (analytical and logical) in its execution. This is not a substitute to the final impression that any ‘experienced’ homoeopath makes after the individualizing examination.

3. The worst that the score can do is to prejudice us regarding the disposition of the individual to be treated by us with nothing but freedom from prejudice (§83).

4. Regardless of the score, keep in mind the CQ can change. It is a quotient that is fluid in nature. People are always evolving. You can help the sick increase her CQ at any point in her life by helping her learn to identify her emotions and taking responsibility for those emotions. And just as easily as the sick can increase her CQ, she can also decrease it. As homoeopaths we must continue to identify and work on areas within the mind of the sick that need work during the course of treatment. Therefore it does not have an absolute predictive value. It’s predictive value is valid only for a limited period of time.

5. Many patients would rather like us to make our own portrait through their story than tell us directly. The questions are ‘direct’ and aim at uncovering their nature directly. We must not pressurize any patient/s if they leave the tests half answered, some questions unconsciously omitted (slip of mind), or when they give excuses that they would complete it at a later date etc. Such reactions need to be interpreted in a different light with tact and circumspection.

6. It is always advisable to take the score in a quiet surrounding, and if possible in your presence (but without any leads from you). The homoeopath must make a special note of what the sick ‘thought aloud’ for the answer of a particular question, or if they take a long time pondering over a particular question, or get lost while attempting to answer any particular question. The best way to take the score is without following the rigid structure in which it is given (for convenience of understanding). The score ideally should be ascertained during an interactive dialogue with the patient (I take the score during a/more than one dialogue).

7. Some of the questions (and its answers) are open to interpretation. Also cultural differences might call for different questions for different cultures (* suggested by Harry Van Der Zee). Example 17. Do I believe in the role of Higher Power (some call it God, whatever name you give) in my life: in health, in disease, and in getting well? Can be reframed to suit other cultures as, Do I believe there is something amazing that is orchestrating me beyond my body, systems, tissues, organs, cells, mitochondria, DNA and RNA?

8. All questions (the 100 I use) are phrased as positive affirmations. It is because the mind as a container accepts and contains in it as truth the words that you give it. Using positive words only as affirmations and leaving out any negative words is meant to trigger a positive emotion in the mind of the reader. The question itself should/ can stimulate the reader to think deep, would act as a reminder if and when recollected later, and this would cause the unconscious to believe in the mental message and can start to work to make them a reality. And therefore they are in first person pronoun ”I”. By questioning like this the “examiner becomes the examinee”. It is similar to what happens when, “the observer becomes the observed ”

9. Among the questions (the 100 I have) some questions are a repetition. They mean the same but are only phrased differently. This is done to verify any ambivalence in the mind of the reader.

10. Many times the answers direct us to the Similimum itself.

Answer of a Migraine patient in exactly the way she wrote on her paper…
1. Yes 2. Yes 3. Yes 4. Yes Specify: More /Less I can’t quantify 5. Maybe 6. Yes I know the cut off point. It is post marriage but Let me tell you I am very, very, very happy in my marriage! 7. Yes 8. Yes! Now you are the one. You are good you understand even without me telling you. 9. Yes 10. With you, you are good at it professionally (No marks) 11. Yes I do yoga once a week. 12.Yes; “a crown of thorns” 13. Maybe 14. Writing/ Sketching (No marks) 15. /No 16. Not applicable 17. Yes 18. Maybe 19. No. All my family members have died of one form of Heart disease or the other. There is asthma too in m family. 20. Maybe 21. Residue symptoms/ etc. (No marks) 22. What would I do after getting well, Imagine? (No marks) Everything is perfect! 23. Yes 24. What does this mean doctor, explain this question. After explanation she answers a Yes 25. No. I believe and have been told always that I have a big body structure for a woman. Although everyone likes my height. 26. Yes 27. Yes I cannot tolerate pain killers and vitamin pills. 28. No I have three children, one mother in law, and three dogs to look after and later is me. 29. Maybe 30. Yes But you must help me. You better be contactable always other wise I feel handicapped without you. And your assistant is not like you. 31. Yes 32. No time for myself (No marks) 33. No. disease is a karmic lesson, why cut short the lesson. No short cuts in learning. 34. No or Never 35. not applicable (No marks) 36. Perfect (No marks) 37. No or Never 38. No or Never 39. No or Never 40. Maybe (Sometimes) 41. No. Will not be needed. You are good. 42. No 43. Yes 44. Maybe/No. I cannot do it alone 45. Maybe 46. No 47. Maybe. Will take some time 48. Maybe/No 49. No. The best sleep I get is during the migraines. I am dead.
She wrote the answers in this fashion to save paper.

Her words of admiration ‘Now you are the one’, ‘You are good you understand even without me telling you’, ‘With you, you are good at it professionally’ are very gratifying to anyone’s ego. But these patients do not recover well. If they do feel well in some presenting symptoms (as medicines act unconditionally) these patients come up with a new set of symptoms. Such a patient often reveal a habit of yielding/leaning to someone (The ‘Dependant’ patient). When they are gently made aware of this habit, they gradually start to wean and get responsible.

She has in her mind the blueprint of the disease of her family. She has a tendency to repress. She needs to learn to express effectively and be able to give time and find time for herself. The ‘me’ has to take precedence over others in certain situations for the disease to be annihilated totally. We need to work with her to bring her to take care of her self and not need the disease (49. No. The best sleep I get is during the migraines. I am dead. )

Her picture of her disease in tune with the internal consistency of her story became a pointer to her remedy (Crataegus). She called it “a crown of thorns” like the one Jesus wore (although being a non catholic)!

Special Note:
*The concept of ‘The CMS model of CQ’ is the foundation of my practice and the credit to this concept goes to all my patients who are my teachers in the 17 years of my practice and also to my mother, ‘Madhukanta Shukla’, a student of psychology with whom I always discussed my experiences, failures and philosophy. These discussions over years crystallized in this concept of CMS (Chetna Madhukanta Shukla/Curability Measuring Scale) model of CQ. The most famous statement representing the main foundation brick of this concept is, “I treat; He cures”. This “He” is the all wise preserver of Human life with whom all human life resonates at an ethereal level (§14). All healings are a result of fine fine-tuning by Him, the infinite goodness channeled to the sick. The role of our medicine is only to give the impetus in the right direction. And as practitioners of Homoeopathy our role is but minuscule in the orchestra of this dynamic symphony of healing.
*Practitioners of Psychology who have taken to homeopathy will find this article philosophical and may find the structure of the questions atypical. The questions are homoeopath oriented and are aimed at working positively towards restoring a stable equilibrium.
Please also read Article Links Spring 2008 Vol. 21: 1-4 title Will to get well: The deciding factor for the choice of Patient.

1. Organon of Medicine by Samuel Hahnemann 6th edition translated by William Boericke (B. Jain publishers reprint edition 1997)
2. “Will to get well: The Deciding Factor For The Choice Of Patient” Homoeopath Links Spring 2008; Vol 21:1-4, By Dr Chetna N. Shukla

We have to treat patients without any prejudice of caste, creed, color, religion, status, belief, age, sex etc. But I believe I have a right to choose my patients in very much the same measure as the patient has the right to choose her homoeopath or any system of medicine (Of course excluding emergencies)! But having exerted this right we are duty bound till the patient gets well or decides to leave us. I believe because I believe that …
* Disease is an adaptive response and has a purpose that needs to be enjoyed by the sick and therefore the sick has created it in her system.
* All restorations of health and all sickness that you are able to heal was only because the sick had a will to get well (and are not your intellectual exploits solely). If you believe in the same than this article would appeal to you.
To get cured (as it is termed) the sick need to receive the impetus from the Indicated Similimum at a point what I like to call the ‘Conversion point’. This is the point in exact resonance with the state when the sick feel the need to not need the disease any more. This point of exact resonance coincides with the presence of this will to get well. In this point they are willing to co-operate by taking responsibility, observing obedience, having endurance and knowing exactly their own role in the restoration work of their wreckage. Their conduct would be like that of an ideal patient. Having recognized this it is the physician’s duty to build bonds of trust, understand and accept the individual’s beliefs, motives, journey, subconscious and unconscious. The most definite way to develop this bond is to stop playing the role of a warrior who is out to conquest the patient’s disease (even if one recognizes it before the patient does). If I recognize that the sick is nowhere close to the “conversion point” I find out the attributes that are contrary to health and work with her to help them transform into healthy attributes that can smoothly pave a way towards health but only with her co operation.

Dr. Chetna N. Shukla
Add: 1, Thelma Apt, Vakola Market Road, Santacruz East, Mumbai 400 055, India
Email: drchetna.shukla@gmail.com

Catégories: Théorie
Mots clés: Health, Disease, Inherent healing, Healthributes (health+attributes), Healthy potentials, Curability Quotient (CQ), CMS (Chetna Madhukanta Shukla) model of CQ, Scoring, Restoration, Susceptibility Quotient (SQ), Will to get well, Conversion point

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