“I Can’t Get Unwound!” A Case of Performance Anxiety


Original patient complaint: Performance Anxiety

Jack, a 38-year-old investment banker from New York, was very pleasant and immaculately dressed. Married with four children, he had worked for two prominent banking institutions over the previous 16 years. “I’ve simply become way too wound up. My sleep is erratic. This year has been a crackers year for me. I actually went to consult a psychiatrist about a year ago because I felt like my wheels were going off the track. I had a horrible experience with Prozac derivatives. My system is sensitive and I reacted terribly. I guess I found out what I didn’t want to do.”
“I put a lot of pressure on myself at work this year. I found myself going over work-related things that hadn’t gone well. I would wake up three to four time on rough nights. The times when I’ve been able to go to bed at ten and wake up at five or six are pretty rare.”

“This year has really brought things to a head. I’m very accomplished at what I do. But when I sit down with a prospective investor, my stomach begins to bubble and my heart races. It feels as if I’m losing control of the situation. My whole sense of calm and self-confidence dissolves. I get too short with my kids and I’m almost too stressed to enjoy sex. The stress stems from work and spills out all over my life. I know the wounds are self-inflicted. It’s the perception of needing to be successful and compete with people at the upper range of achievement.”

Fortunate to enjoy very high energy, Jack was up at 5 A.M., he bounced out of bed and was ready to go without ever needing a caffeine boost. In fact, caffeine “destroyed” Jack. A habitual self-critic, he was extremely demanding of himself and his accomplishments. When seized by tension, Jack’s breathing became shallow, his back and neck constricted, and his stomach felt tight. His psychiatrist likened him to a A student who had to keep up his grades. Losing was a big deal for Jack. As far back as grade school, losing a baseball game was a serious matter. He just got used to winning. In everything. Honest and believable, he had excelled in his career, yet he continued to feel overwhelmed by a fear of being unsuccessful.

Jack’s bottom-line feeling was being out of control. No matter how large an account he was able to secure, he continually fixated on “screwing up”. When he compared his performance with that of his professional colleagues, as he did frequently, his sense of inner calmness evaporated. He was consumed by thought, worry, and anticipation. As we interviewed Jack in more depth, we discovered that his first panic attack occurred 18 years earlier in his first business class. As he got up in front of a group of 30 or so other students, he became lightheaded, drenched in perspiration, his heart raced, and he had to sit down. That incident instilled in him a fear of looking stupid, out of control. What if the situation repeated itself? Over the years it did, so frequently in recent times that he was determined to find an answer other than antidepressants.

Jack loved breakfast and considered himself “a bland food kind of guy”, and “an ice cream fanatic”.On a recent business trip to Geneva, Jack had indulged in “way too much red meat and red wine” and felt horribly hung over the next day. “I think it would take me a week to digest a Porterhouse [steak].”

In Jack’s case, it took a little over a year to find the medicine which had the most profound effect on him. Our readers will not be surprised to hear that we first prescribed Nux vomica (Quaker’s button), a common homeopathic medicine for an overstressed, irritable, hard-driving, Type-A-personality kind of guy. The remedy seemed confirmed by Jack’s aggravation from red meat and red wine. No success.

We then ascertained that Jack needed one of the medicines made from metals. These individuals place a very strong emphasis on performance, success, and reaching a great height in their career. Highly responsible, they are usually high achievers but experience a great fear of falling from the position they have worked so hard to achieve.
Jack’s case was a challenge for us. After trying Titanium, Aurum metallicum (Gold),
Rhodium, and Niccolum (Nickel), some of which had a partial effect in helping Jack, we arrived at Cuprum metallicum (Copper). Just as with conventional medications, it can take time to find the very best homeopathic medicine for an individual, though generally not more than six months.

The main feature of someone needing Cuprum is a firm desire to maintain control.
Serious, conscientious, responsible individuals. they push themselves very hard. They make excellent leaders and can be depended upon to follow through with their commitments. Like the other metals in homeopathy, these people can have a great fear of heights, which was true of Jack. As a child his most vivid dreams were of falling from a very high place. “I’d wake up before I would go splat.” Jack did not suffer from the muscle cramps typical of those needing this medicine, but did incur an injury to his calf muscle which inhibited his running routine. He did, however, complain of stomach tension and Cuprum is quite well-indicated for stomach cramps.

After taking Cuprum 1M, we didn’t see Jack again for 5 months. A busy, practical fellow, he didn’t feel a need to come see us since he was doing so well. The notion of losing control had rarely even occurred to him. He felt like his old self who didn’t get wound up about meetings or presentations. The sensation of observing and judging himself had disappeared. His sleep had also improved. What brought Jack back in to see us was a return of the anxiety, though no as severe as before the Cuprum, after he drank coffee at a friend’s birthday party a month earlier. A meeting with a high-powered client was scheduled the following week and he definitely needed to feel himself again. It was evident to Jack and to us that the coffee interfered with his progress and we repeated the medicine in the same potency. Jack again experienced an immediate positive reponse to Cuprum 1M until another encounter with coffee at which time we gave the remedy the third time.

Cuprum is a remedy which can, as in Jack’s case, be easily missed. We find it to be most recognizable in patients who are very domineering and dictatorial (delusion he is an officer; delusion he is a general;delusion he is a great person ). James Tyler Kent called this remedy one of the three great remedies for life-threatening diarrhea. Sankaran comparesCuprum to Zincum , both of which he explains, perceive themselves under the threat of attack, Zincum more continuously and Cuprum intermittently.

It was Jan Scholten’s Homeopathy and the Elements that led us to choose Cuprum in this case. Cuprum, like other metals in the Ferrum series, according to Scholten, deal with work, duty, perfectionism, rules, observed criticism, failure, guilt, and crime. Stage 11 of the periodic table of the elements in which Cuprum is situated, involves holding on, preserving, maintaining, and protecting.Cuprum, according to Scholten, is all about maintaining control. He views these individuals, as is true in other materia medicas, as serious, hard workers who are precise, follow the rules, and are very sensitive to criticism and to others interfering with their affairs. Scholten’s schema is brilliant however we and some of our colleagues have found a number of seemingly very-well indicated remedies, according to his materia medica, to yield no benefit. This is particularly true of the very new and small remedies. It seems that we need thorough provings and significant clinical experience with these remedies. This case was one in which Jan’s methodology proved to be very successful for the patient.

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