The emotional body in Chinese medicine

on 01/26/2013 by Mauricio Quintana in Foundational Science

Note from the author, Mauricio.

Kimberly Brown, a fellow contributor to Deepest Health, recently reviewed a book I'd been meaning to read for a while now, Zhang Yanhua's Transforming Emotions with Chinese Medicine. I was inspired to pick it up from the shelf and am now halfway through the book. I'm really excited about some of the subtler, albeit very important, distinctions that Zhang draws about the way that "emotions" and emotional disorders are conceptualised and treated by Chinese Medicine in China.

It is deepening my understanding of things I heard my lay-daoist teacher speak about many years ago, back when I was in school. This post represents a bit of my own understanding of what is actually going on when approaching treatment of illness with a strong emotional-affective component from a Chinese Medicine perspective. Being one of my favourite areas of clinical work, I hope to write more on this topic when I finish reading the book.

Feel free to comment and add your own opinions and experiences in this regard.

At the heart of the healing work of Chinese Medicine is the fundamental assumption that what we in the West term "body" and "mind" are actually one same thing.

At essence an affective, somatic, and physiological construct that is at once a tangible manifestation and a self-aware, reflective learning process.  There is a very famous passage in Chapter 8 of the lingshu that says "All disease is rooted in the heart" — in Classical Chinese Medical thinking, "heart" and "mind" are synonymous. The rest of that passage goes into detail about what sorts of illness arise from a person's emotions and states of mind, as well as putting forth several ideas about how the cognitive process works, and how apprehension, comprehension, and interpretation of experience happen for us humans.

Photo by Izabelha – 2005 – http://www.sxc.hu/profile/Izabelha

In the West, we who study Chinese Medicine learn about this fundamental characteristic early on, as part of our introduction to Chinese Medical theories, and are fascinated by the idea of being able to treat a person as a whole.  Unfortunately, in practice very few of those ideas find practical application. Part of the problem is, regardless of what we've learned in class, the idea of separateness between body and mind is deeply entrenched in our Western minds.

Our clinical orientation is mostly towards treating "physical" illness, and very few of us receive any training in counseling or other forms of approaching the affect-mind of our patients. Many Chinese Medicine doctors I've met over the years keep an eye out for the emotional component of their patients, but they assume that it must be getting dealt with, secondarily and almost as an afterthought, as an extension of dealing with the "real" somatic manifestations of the disease.

However, in my opinion, it is precisely this connection which makes Chinese Medicine so valuable and effective in creating and maintaining health: its ability to understand and treat all kinds of pain, regardless of its origin.

Although Western Medicine is finally beginning to warm up to the idea of connection between body and mind, the prevailing understanding in the West is  quite removed from this Chinese concept of a real continuity between emotions and physical manifestations of disease.  Most of the time doctors pay little more than lip service to the idea.

In the eight years since I left school and went into private clinical practice, I've consistently come back to this issue of really addressing the emotional component of illness in every case.

Thankfully, I was exposed to a very old tradition of Chinese Medicine that emphasized 情志病 qingzhibing treatment.  I also got relatively far into the practice of a style of 導引 daoyin that delves into something that I'd never heard before: the idea that emotional trauma and pain are located in the physical body, and can be brought to consciousness and resolution through physical exercise and awareness practice. Armed with these two tools, I've been relatively successful in working with patients who've been willing to include their emotional experience in their treatments. I've often approached the actual emotional issues at hand with "talk therapy," and then incorporating that knowledge and awareness in the treatment with needles, herbs, and so on.

This is treacherous territory for any Chinese Medicine practitioner in the West. It requires stepping back and reassessing the situation from a different perspective; one that forces the confrontation of the lived experience of the patient, pretty much on its own terms. However, there are rewards to this. I'd like to share with you some of the main pointers that I follow in incorporating this kind of "emotional awareness" into my treatments. First is my observation that, in terms of the real, embodied experience of a patient, the "cause" of the discomfort makes little difference; pain is pain.

Pain is at once a Universal and a personal experience.

Each one of us has experienced pain at some point in our lives, and it is guaranteed that we will continue to experience pain many more times while we're alive. Chapter 13 of the daodejing says: "Accept misfortune as the human condition… Misfortune comes from having a body. Without a body, how could there be misfortune?"

We can talk about our pain, describing it in detail, and other people will have a more-or-less clear idea of what we are expressing.  Likely because they have experienced something similar at some point: stress, past wounds, trauma, loss, insults, accidents… However, no other person really "understands" our pain. We're all alone in there, and this reality can be very difficult to grasp when working with another. The second thing that becomes clear is that responses to pain are unique, as many and as different from each other as the people who experience the pain. These responses are part of what gives us our sense of identity: the way we respond to our pain tells us who we are.

In Buddhism and other Eastern traditions, this is known as "suffering": the organisation of a person's identity around their pain.

These responses do not occur only in the mind. According to the Chinese Medicine school of qingzhibing that I studied and mentioned before, a person's perceptual interface (that is, the place where the mind interacts with its surroundings) is located in all of the body's tissues. Those knowledgeable about five-phase correspondences will recall that thought and worry are related to the Spleen, which is in turn related to the flesh of the body.  This is important. In these terms, the body and its sensations become a practical key to access the emotions during treatment.

Unwinding the body's tension — or habitual holding, to borrow from bodywork terminology — should have some real effect on the emotional manifestation while simultaneously relieving any somatic distress. In my experience, this happens quite frequently in treatment, provided the patient is made aware of their emotional distress going into the treatment. This makes sense, since we Westerners spend so much time "in our heads" already.  It simply blows me away how ubiquitous emotional components really are in patients' experience of their disease. The fact they don't bring it up more often is due quite simply to their own, culturally-bound assumption that it is something separate that needs to be addressed elsewhere.

It is crucial to approach the patient's pain respectfully, compassionately, and empathically. It must be done gradually, so as to comprehend (inasmuch as possible) the relationship that the patient has with their body and their pain. Opinions and judgments are irrelevant and useless. In fact, they can actually be detrimental. Pain exists because it is the only response that makes sense: in my experience, all cases of illness or suffering involve a relationship of the patient with their experience that manifests at all levels — physical, emotional, mental, even spiritual.

More importantly, the physician must maintain the continuity of physical pain, postural habits, emotions, and identity in mind at all times.

Unless it is approached this way, the patient's suffering cannot be resolved. Why is this? In my opinion, it is because of what the daodejing says, namely, that our "misfortunes" arise from having a body. Actually, everything about being human is a function of embodiment. The body isn't a "vehicle"; it is what and who we are. We are our bodies; we also are all of the manifestations, internal and external, of those bodies. This is why we all, consciously or unconsciously, demand at all times "proof" that what we are feeling in our subjective experience is "real", especially when it is uncomfortable.

Think on it. Access to the more subtle levels (emotional, "energetic", spiritual) is always mediated by an embodied experience. What we perceive is immediately accessible to us. Moreover, it is incontrovertible: we feel pain, and we also know when it has been relieved (or not), regardless of what anyone else says. Therefore it is important to address the experience of pain and suffering in order to alleviate its manifestations effectively, and also to help the patient understand the root of the problem.

Out of the constant interplay of the medium (body) and the forces that move through it (emotions), arise our thoughts and interpretations.

Our consciousness is the emergent function of all of these together, and cannot exist divorced from any of them. It is at the interface of these phenomena that the Chinese Medicine doctor can work his craft and truly attain the ideal of "holistic treatment" that addresses physical, emotional, mental, and other, more subtle levels at once. From this perspective, it behooves us as Chinese Medicine practitioners to look for the places where body, emotions, and thinking meet to create the unique phenomenon of life that presents itself before you.

Our job in this context is to aid manifestation and resolution, rather than "fixing."

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