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Traditional Chinese Medicine as a Basis for Treating Psychiatric Disorders: A Review of Theory with Illustrative Cases Copy

Citation: Aung, S. K., Fay, H., & Hobbs, R. F., 3rd (2013). Traditional Chinese Medicine as a Basis for Treating Psychiatric Disorders: A Review of Theory with Illustrative Cases. Medical acupuncture25(6), 398–406. doi:10.1089/acu.2013.1007

Full Paper available for free at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3870484/

Abstract:

Background: Integrative medicine is becoming increasingly accepted in the global scheme of health care. Traditional Chinese Medicine (TCM) is often included among integrative medicine modalities.

Objective: This article provides a background for integration of acupuncture and other TCM-derived approaches to managing psychiatric conditions.

Methods: Classical theories of TCM that pertain to psychiatric conditions are reviewed, focusing on concepts of energetic imbalance, the implications of mind–body–spirit connections, and treatment strategies that involve TCM modalities. An example of correlation between TCM patterns of disharmony and the Western diagnosis of generalized anxiety disorder (GAD) is given, along with an illustrative case in which counseling, medications, and acupuncture were combined in treatment. TCM principles are incorporated in certain energy psychology modalities, such as Emotional Freedom Technique (EFT). A case is presented demonstrating the integration of energy psychology with acupuncture, Qigong and hypnosis as an avenue for releasing pathogenic emotions. In classical TCM theory, assessing and treating spiritual disharmonies is fundamental for dealing with emotional disorders. Practical application in a clinical case is described.

Conclusions: TCM offers a cogent theoretical basis for assessing and clinically managing patients presenting with mental health issues. TCM principles integrate well with other systems, including Western medicine.

Key Words: : Psychiatric Disorders, TCM, CAM, Integrative Medicine, Acupuncture, EFT, Hypnosis

 

Craig’s Comments:

This is a fascinating research paper performed by three MDs, one of which is also an OMD, Doctor of Oriental Medicine, and performed as a collaboration of a Canadian/US integrated medicine project to explore TCM (Traditional Chinese Medicine) approaches to working with psychiatric disorders in combination with other techniques including EFT, Qigong and hypnosis.

This paper discusses how the use of acupuncture, EFT and other approaches that are based on Traditional Chinese Medicine and meridian work can be helpful in managing different psychiatric conditions.

The authors discuss the correlation between the Western diagnosis of generalized anxiety disorder and the Chinese Medicine theory of “patterns of disharmony.” They cite a case where counseling, medications and acupuncture were combined in a successful treatment. They also describe a case in which EFT is shown to be therapeutic. They describe practical applications of various alternative methods and conclude that Traditional Chinese Medicine can be helpful in assessing and helping patients with mental health issues, and that it integrates well with Western medicine.

I think that papers like this, as case study published papers offer us great insight into collaborative models of care that need to include EFT to explore the role that it can play for reducing heightened emotional states like fear, stress and anxiety that can play a significant role not only in psychiatritic disorders as explored here but as well as in other chronic physical conditions as in the case of this individual recently diagnosed with carcinoma.

Three case studies were presented in this paper with varying presentations and treatment protocols:

Case #1. Acupuncture with Westen Medicine Approaches for severe anxiety and PTSD

Case #2: EFT, TCM, Qigong and Hypnosis for a patient with severe anxiety who had recently been diagnosed with squamous-cell carcinoma of the neck

Case #3: Case #3: Spiritual Approaches (Qigong) to Healing for a patient with  chronic somnambulism (sleepwalking)

 

Here is their case study that included EFT as a component:

History of Present Illness
A 50-year-old male presented for treatment for severe anxiety and fear. He had recently been diagnosed with squamous-cell carcinoma of the neck. Many positive cervical nodes were evident but no primary site was identified. Management included cisplatin followed by radiation. In the interim, just prior to the diagnosis of cancer, this patient had been experiencing stress, related to a complex relationship with his father and that was amplified by this patient having recently joined a family business.

TCM Assessment
This patient had Blood and Qi Stasis manifesting as malignant tumor; KI Yin Deficiency (from chronic stress) affecting the Zhi and causing fearfulness; LR Qi Stagnation from frustration and resentment pertaining to the patient’s relationship with his father, resulting in LR Fire, LR Yin Deficiency, LR Blood Deficiency and an associated disturbance of the Hun; HT Yin and HT Blood Deficiency, propagating from LR Deficiencies, causing an associated disturbance of the Shen and anxiety.

Treatment
The Emotional Freedom Technique (EFT) was used to dissipate harmful emotions. Hypnosis was performed, with the focus being visualization of a healthy state in both past and future lives. The hypnotic state was also used to promote clear self-expression.22 Acupuncture was used in conjunction with the other modalities to improve the patient’s sense of well-being and to help relieve the physical symptoms he had related to his cancer and cancer treatment.23–25

In this case, EFT was targeted toward resentment of the father. Acupuncture points included GV 20, Sishencong, Yintang, HT 7, ST 8, ST 36, ST 40, LI 4, LI 11, CV 6, CV 12, CV 17, GB 39, LR 2, LR 3, KI 3, and K I7.

As part of self-care, the patient initiated the practice of Qigong.

Results
During his cancer treatment, this patient experienced minimal xerostomia and ate normally. He was able to simplify his life and to adopt a more-positive attitude. Five years later, he remains in excellent health with no recurrences of his cancer and has resolution of his anxiety and fearfulness.

 

Here are the authors’ comments regarding the integration of EFT/Energy Psychology interventions with TCM:

When dealing with psychologic or psychiatric conditions, an initial assessment of energetic imbalances, based upon the diagnostic methods of TCM, is made with special attention toward what thoughts, feelings, emotions and memories have been, and continue to be, contributing causes. Difficulties arise, at the energetic level, when a persistent, strong emotion has not been acknowledged, processed, and released. In such cases, emotions become endogenous pathogenic factors, capable of causing energetic disharmonies that may lead to symptoms or disease. For example, when a patient presents with prolonged grief and depression after the death of a loved one, a discussion may allow the patient to identify anger as an underlying emotion—anger that the person left them. From a TCM perspective, anger results in Liver disharmony, which frequently manifests as depression. The anger needs to be cleared in order to lift the depression. Energy psychology, especially Emotional Freedom Technique (EFT), is most useful when the patient is ready to acknowledge the underlying emotion and to focus on that feeling.31 Energy psychology techniques help to ratchet down, clarify, and clear the emotions that are contributing to the imbalances and the distress. EFT involves intentionally experiencing the negative emotion while stimulating a sequence of acupuncture points, allowing the emotion to be released. During the intervention, other feelings, emotions, and memories often register in the patient’s mind. These may be from other recent or even very old experiences that have set up beliefs, attitudes, and expectations in the person. Noticing the residua of previous experiences may help clarify the issues that are contributing to the current intensity of distress. For instance, abandonment as a child may result in an adult reaction that is out of proportion to a loss.

The subconscious mind does not mark the passage of time in a linear fashion. Therefore, any memories and feelings associated with those memories are experienced in the subconscious as if they are happening today. In PTSD, painful emotions are associated with memories of trauma. A recent study has demonstrated that EFT is effective for treating PTSD. The memory remains but the emotions have been released.

Energy psychology and acupuncture work well as a sequence in treating emotional disorders. In one approach, after energy psychology techniques have been utilized, acupuncture needles are inserted at GV20 and Yintang to help calm the mind and promote insight. Frequently, at the time of a traumatic event, a natural response is to “close the gates.” In other words, a self-protective isolation occurs. A consequence is that whatever emotions were present at the time of the trauma become locked-in, unable to be released, resulting in an association between memory and emotion. An acupuncture approach is to open the gates by needling PC 6 (Neiguan, Inner Passage) and TE 5 (Waiguan, Outer Passage). When there is a need for forgiveness of self and/or others, HT 7 is needled. Issues of anger are helped by needling LR 2, which calms the Liver Fire and LR 3, which helps promote the smooth flow of energy. When there is Liver Fire and Excess Heat, then cupping CV 12 and ST 25 can help disperse Heat. These steps permit the patient to connect better with any emotions that are being brought to a higher level of awareness.

After EFT and acupuncture, addition of hypnosis is often beneficial for identifying repressed memories and blocked emotions. While the needles are working the patient is helped to enter a hypnotic state. Needling CV 5 facilitates induction. It has recently been found that work being done in a light or medium trance state can be more effective than when in a deep trance state. The patient is guided to a safe, private place, usually a place in nature that can be real or imaginary. Once this state is achieved, all the senses are awakened; this helps to focus the hypnotic state. Then, in the mind’s eye the therapy is guided by what was elicited in the information already gathered. When there is a physical issue, that area can be visited and a dialogue set up with this issue, asking why it is there, what emotions are connected with it, and what needs to be done or not done for it to resolve and allow the patient to return to health. The answers come from the patient’s deep inner wisdom and the connections with emotions, memories, and feelings become clearer.