EXAMINING THE ANALYTICAL APPROACH
By C. J. Wansbrough Homeopathic Links Volume 18 Autumn, 2005 3/05

‘The suicide warriors, who attacked Washington and New York on September 11th 2001, did more than kill thousands of civilians and demolish the World Trade Centre. They destroyed the West’s ruling myth.’
Thus begins J. Gray’s polemic on the nature of Al Qaeda and the nature of modernism.
He argues that Western societies are governed by the belief that modernity is a single condition, everywhere the same and always benign. This ethos was based on the Age of Enlightenment. From the eighteenth century onwards the growth of scientific knowledge and the emancipation of mankind marched hand in hand. From the dominating influence of the scientific model together with the forces of colonial expansion, the West assumed that its influence would soon be accepted everywhere.
Through the power of reason and science, humanity would be able to create a new world order. This was never true, yet our faith in science and reason produced this deception.
The underlying theme, from the Age of Enlightenment, was great faith in the power of reason, rational man would triumph and humanity would emerge in a new world order.
What placed the stamp on the Enlightenment was the analytical method derived from Newton and Descartes. Order and regularity came from such an analysis of observed facts and from then onwards, ‘rational man together with the power of science’ became the only determining activity in the pursuit of truth.
The Homeopathic paradigm is a product of the Enlightenment. Samuel Hahnemann and his followers were driven by their overriding passion for generating a rational model that would challenge the existent model of medicine at that time.
The ‘Classical model’ is a product of the Enlightenment. No cliché is more stupefying than to expect such a traditional model to cope with the 21st Century.
In the same way that Al Qaeda challenges the monolithic model of benign scientific enlightenment, that we call progress, and demands another perspective-in the same way ‘the Classical model’ needs to be challenged !
But having listened to some extraordinary claims about the scientific basis of the homeopathic model from a number of practitioners, I wish to question the educational edifice that has been constructed on the basis of this analytical approach to the homeopathic domain.
In order to tease apart and understand the expertise involved in finding a remedy, we need to not only study and learn from all ‘modern masters’ of homeopathy, but also understand the underlying processes that allow such masters to excel in such a field.
The ongoing debate between the ‘classical approach’ and the ‘neo-classical approach’ can be approached by actively examining models in ‘cognitive psychology’ that were designed to understand how ‘experts’ makes decisions within the confines of a normal working day. In other words, how ‘experienced homeopaths’ under the pressures of a normal working day faced with inadequate or ambiguous information were able to make find ‘the correct remedy’.

MAKING DECISIONS
In the final analysis, homeopathy is about recognising patterns, its primary aim is to extract information from the patient in such a way that it allows the practitioner to recognise a set of cues or a narrative that will allow him to prescribe the remedy. In order to understand how this process occurs, Gary Klein, a cognitive psychologist was asked by a U.S. Army Research Institute to study the underlying methods that experts used when under pressure and out in the field. The following model and ensuing discussion can all be found in G. Klein’s book ‘Sources of Power’.(2)
His remit was, to study how ‘experts’ in their field came to decisions, and so he set about studying, Fire-fighters, nurses, doctors, the military and various other professions to gain insights in how expertise unravelled in situations which were time pressured and natural.
Humans and animals make inferences about their world with limited time, knowledge, and computational power. Many models that use analysis as the primary basis for making inferences take the view that the mind has immense abilities to reason, enormous knowledge and much time to make decisions. In essence this educational model conflicts with reality.
The homeopath may well be trained to think in an analytical mode that will enable him to apply certain laws of logic, but the immense knowledge that is needed (even with computers) to engage with our vast materia medica, together with the ensuing ambiguity which can arise from a prescription conflicts with ‘the real world’ of the time pressured practitioner.
In order for G. Klein to study the pressures of decision making in the real world, he took a model devised by P.Soelberg on rational analysis strategies.(3)
This model contained the following rules

The Decision Maker :
• Identifies set of options ( Identify set of remedies in case)
• Identifies ways of evaluation (evaluate different remedies pictures)
• Weighs up each evaluation (weigh up each repertorisation)
• Rates the process
• Picks the one with the highest score
THIS PROCESS IS VERY SIMILAR TO THE HOMEOPATHIC ANALYSIS OF A CASE
Peer Soelberg, then studied the decision strategies his students used to perform a task, e.g. select jobs
He assumed that they would rely on this rational choice strategy.
He found her was wrong !! VERY VERY WRONG
His students showed little inclination towards systematic thinking instead they relied on ‘gut feelings’.
So what did they do ???
In order to make a decision they had to go through a systematic process of evaluation so they compared two options. But they unconsciously selected their favourite then picked an alternative, tried to show this was worse than their favourite and then announced their selection.
WHAT WAS ACTUALLY DONE WAS NOT A DECISION PROCESS BUT CONSTRUCTING A JUSTIFICATION!!! How often do we as homeopaths construct a justification for a remedy that maybe as a result of an intuitive hunch or some peculiar synchronistic event that happened to occur just at the right moment in time!!
Gary Klein took this model of comparative evaluation as his starting point in trying to understand how experienced individuals made decisions in the field.
He used this hypothesis to study how experienced Fire-fighters made decisions under pressure while out in the field, his assumptions were that an experienced individual might make two comparisons, then intuit the best one, and act on this ‘hunch’.
In fact he found that they never even used this model, even more disturbingly he found that the
EXPERIENCED INDIVIDUALS NEVER MADE DECISIONS

RECOGNITION-PRIMED DECISION MAKING MODEL
He found that the secret to the success of such expertise was their experience; it let them see a situation, even a non routine one, as an example of a prototype, so they knew the typical course of action immediately.
They were being skilful and this strategy is called the RECOGNITION-PRIMED DECISION MAKING MODEL
In other words what was found right across the board in all the various categories of expertise, was that the expert did not evaluate or analyse the process, but assessed the situation and judged how familiar the situation was!!. The point about the model I wish to make, is that expertise firstly recognised the situation because there can be no analysis without recognition.
The following diagram is adapted from G. Klein’s model and though there are of course variations on how this process is carried out , it does lend credence to our endless need to post-rationalise remedies that we have found worked.
After all every prescription falls into the category of “guesstimation” - a plausible guess. (4) There are no correct prescriptions until the patient returns with a complete evaluation of the effects of the remedy. It is a ‘virtual prescription’ until the patient returns confirming the accuracy of that prescription.

VARIATION ONE SIMPLE MATCH
This is basically an ‘if----then’ reaction, an antecedent followed by rule-based response,
i.e. expertise is able to recognise when conditions have been met.

There are variations on this model but the point is that the experienced practitioner recognises a situation and then prescribes on this prototype before even deciding another course of action.
How we make decisions or diagnose situations using this model is very similar to how people make sense of the facts when asked to make a jury decision about the innocence or guilt of a defendant. N. Pennington & R. Hastie (5) studied this process. According to these researchers people listening to the evidence in complex cases, have trouble cataloguing every piece of information and its implications. Instead, they build stories , or mental simulations trying to fit the evidence into a plausible account of the crime. They actively try to build their own stories and then compare them to the two lawyers and then select that one that matches their story best. This story model describes how we make diagnostic decisions.
We listen to the ongoing narrative of the patient, try and make sense of the sometimes ambiguous information and then extrapolate so that we build up a story. After we have gradually built up some sort of picture we will then try and match it to information we have already from our past experience or we will ‘play’ with the repertory and search certain rubrics that might trigger off associations in our past experience that might match certain aspects of the narrative collected.
I have no intention of going into detail over this model, the complexities can be accessed from books but it must be emphasised that the same strictures of time and ambiguity face the homeopath as most other professional expertise. Furthermore, it has been found that the RPD model of making decisions has not only been widely accepted by many decision makers but it has been found to apply to between 70%-90% of all cases of expertise that were called on in natural or time-pressured circumstances.
In essence this means that the so called ‘split’ between the ‘classical and neo-classical’ practitioners is a spurious and trivial debate as G. Vithoulkas in his expertise will be applying the same processes as R. Sankaran, it is more in the details than in the process that disagreements will arise, since both individuals will have to recognise ‘something’ in order to even begin to analyse it!!
My suspicions are that in watching ‘expertise’ in the field of homeopathy it very much fits this ‘recognition model’. I suspect that ‘expert homeopaths’ recognise some prototype i.e. a similarity to a polycrest picture then search out or notice some violations, and then apply the various sources of power elaborated below. How or in what way, depends on their previous constructs and conceptual frameworks around the homeopathic domain.

SOURCES OF POWER
I now wish to cast a cursory glance at what G. Klein calls, sources of power; those abilities that are called upon by experts to make rapid and correct decisions.
His major sources of power, can be categorised under a number of headings
1. The Power of Intuition
According to his investigations into expertise, he found that intuition was a major source of power in enabling the expert to find the correct solution. He found that intuition depends on the use of experience to recognise key patterns that indicate the dynamics of a situation. In fact, G. Klien defines intuition as ‘the way we translate our experience into action’. Our experience allows us to recognise what is happening and consequently allows us to make decisions. Nevertheless intuition has a strange reputation since it is difficult to pin down, even though it does seem to have some basis in biology. For example, Bechara, Damasio et al. (6) compared brain damaged patients to a group of normal subjects. The brain-damaged patients lacked the ability to generate emotional reactions and anticipate the consequences of bad and good decisions, unlike the normal group that developed this ability even before even being conscious of this fact.
G. Klein, found this to be the major ability in all categories of expertise he studied, and will apply to all forms of expertise in the homeopathic community, whatever their belief structures.

2. The Power of Mental Simulation
This ability really refers the ability to use the imagination creatively. This refers to the ability to imagine people and situations consciously and the ability to transform them through several transitions and thereby see them in a different way than at the start. It involves a certain quality of empathy that allows us to project how the present will move into the future. It refers to that ability how we can act as containers or even mirrors that enable the patient to see ways out of his dilemma.

3. The Power to See the Invisible
This is especially pertinent to expertise. One view of expertise is that they have lots of accumulated knowledge and this takes many years of experience to search through these vast archives of knowledge. In reality what distinguishes the expert from the novice, is the ability to see things the rest of us cannot. They can exclude a vast amount of data which is not pertinent to the situation and just concentrate on what is to them the most obvious problem.
Experts can see
• Patterns that a novice does not notice
• They can see anomalies, i.e. violations that are not expected
• The Overview and not get bogged down in detail
• The way things work
• Differences that are too small for novices to detect
• Their own limitations.

4. The Power of Stories
The ability to create effective narratives is a key source of expertise. It enables the expert to manage and organise a large amount of information into a meaningful framework. They also act to network a vast amount of data from their causes to their effects. This is the primary source of power that homeopaths use in transferring expertise to novices by writing up cases as ongoing narratives that enable novices to extract subtle aspects of expertise.

5. The Power of Analogue Thinking
People use analogues and metaphors to perform a variety of difficult tasks: understanding situations, generating predictions, and solving problems.
An analogue is an event or example drawn from the same or similar domain as the task at hand. This is a major source of power in the expertise of some homeopaths since it enables to group and select domains and themes that might apply across similar domains. Scholten’s use of the periodic table is a perfect example of analogue thinking, which acts as a powerful source of extrapolating possibilities which might never otherwise be accessed.

6. The Power of Metaphor
Metaphor can be defined as a mapping or transfer of meaning between dissimilar domains. Metaphor not only transfers meaning between different domains but by means of novel recombination’s can generate new perceptions . Imagination could not exist without this ability for metaphor to produce novel ideas. Research into metaphor has found that they can affect what we see and how we interpret it. Lakoff and Johnson in a famous book, Metaphors We Live By (7), showed that metaphors can govern the way we think about issues. The metaphor Arguments are war throws up a way of thinking that engages us in attacking each other’s weaknesses , while Arguments are like Music practise shifts our thinking towards ways of how each of us contributes to disharmonies.
Another example is the primary metaphor of verticality and balance. Feeling in balance, upright and preserving an up-down posture in space against gravity feel ‘good’. This bodily or corporeal feeling is then mapped onto other domains metaphorically and universally. The assumptions are that up means an increase in quantity and down the reverse. Stocks markets go up and down, people take ‘uppers’ and ‘downers’. Feeling good means things are ‘looking up’ feeling bad means things are ‘looking down’. There is no reason why an increase in quantity or the values good or bad should be associated with verticality. As Johnson (9) observes this metaphor is so basic in how we organise experience that it seems odd to question it.
What is certain that the homeopathic community have evolved plenty of complex metaphors to enable different perceptions and interpretations of cases, from the use of the Circle and the Four Elements predominantly used by the Israeli homeopath Joseph Reeves, to a Theory of Multiple Miasms used by Rajan Sankaran. Each system denotes a metaphor that facilitates thinking by mapping one type of thinking onto a different domain.

THE PROBLEMS WITH RATIONAL ANALYSIS
The purpose of this article has been to explore a model of expertise that many Cognitive psychologists now agree on and to demonstrate that expertise uses many more sources of powers that just analytical or rational methods. Rational analysis is a powerful source of power and has produced an extraordinary growth in science and technology and medicine, but is limited when applied to situations that are endlessly changing as experiences of patients are constantly updated and changed. Our ability to use intuition and pattern recognition is based on experiences that are facilitated by those sources of power mentioned above. In contrast, our ability to use rational and analytical thought is independent of experience.
To perform an analysis means breaking down a situation into its constituent parts, but as we know from the variation in homeopathic schools of thought, there is never a ‘right way’ to break down a case. Different people will choose different schemes and I suspect that most people use a combination of analytical and experiential sources of power to find remedies. We can not afford to rely on the analytical method as our only source of power since it clearly has limited applications in the field of expertise.

CONCLUSION
My aim in this article was to explore a model of expertise that I suspect experienced homeopaths use all the time. It is a model that was persistently examined for flaws over a number of years, and has been applied across a wide range of professional expertise. The model draws across many disciplines and cuts across any particular beliefs that different homeopaths in the community might hold dear, since it examines the underlying cognitive structures that allow humans to function under time pressured domains.
As homeopaths we have limited time and knowledge, and few individuals in the community have the experience or knowledge, as such eminent homeopaths as George Vithoulkas. Instead we must re-examine and cross-discipline to other domains, (in other words use different metaphors) to discover how we think and how we make decisions, it is not enough to continually pursue a particular way of thinking (i.e. classical homeopathy) if we face what I would call ‘a materia medica meltdown’ as we try to constantly process information as though we still held dear the precepts of ‘The Age of Enlightenment.’
We cannot manage the information that we are now faced with, even though we have computers, instead we must examine our ways of thinking to help us process this ‘explosive amount of information’ that we are faced with, and this exploration lies in the developing field of neurobiology.

1. Al Qaeda and what it means to be Modern John Gray Faber & Faber (2003)
2. Source of Power by Gary Klein MIT Press Cambridge, Massachusetts (1998)
3. Soelberg, P.O. Unprogrammed decision making. Industrial Management Review 8: 19-29 (1967)
4. Edited by R. Davis-Floyd & P. Sven Arvidson Intuition the inside story Routledge (1997)
5. Pennington, N. & Hastie, R. A theory of explanation-based decision making. In G. Klein, J. Orasanu, R. Calderwood , and 6. C.E. Zsambok (eds.) Decision making in action: Models and Methods, Norwood, NJ: Ablex (1993)
7. Bechara, A., Damasio, H., Tranel, D., Damasio, A. R. Deciding advantageously before knowing the advantageous strategy. Science 275: 1293-1295 (1984)
7. Imagination and the Meaningful Brain by Arnold H. Modell MIT Press (2003)
8.Lakoff, G., & Johnson, M., Metaphors we live by, Chicago University of Chicago Press (1980)
9. Johnson, M., The Body in the Mind, University of Chicago Press (1987)