Body Mind and Emotions in Acupuncture-Libre

The mind in the use of acupuncture
The mind in the use of acupuncture

How can we best help our patients to become- and remain healthy
By Alexandre Djukanovic
Supervised by: Marijke Fluitsma
December 2012
Academy for Chinese Medicine, Qing Bai
Contents
The mind in the use of acupuncture ............................................................................................................. 1

Contents .................................................................................................................................................... 3
Conclusions ............................................................................................................................................... 4
Foreword................................................................................................................................................... 6
Preface - Methods..................................................................................................................................... 9
Introduction ............................................................................................................................................ 11
Choices related to our environment ................................................................................................... 11
Jing-Qi-Shen and wellbeing ................................................................................................................. 16
Health .................................................................................................................................................. 19
Disease ................................................................................................................................................ 22
Summary for health and disease ........................................................................................................ 27
Mind and emotions ................................................................................................................................. 28
Chapter outline ................................................................................................................................... 28
Mind .................................................................................................................................................... 29
Emotions ............................................................................................................................................. 30
The Heart ............................................................................................................................................ 30
Aspects of the five Shen ...................................................................................................................... 33
Description of Emotions, ..................................................................................................................... 38
Objective subjectivity .......................................................................................................................... 43
Examples of diseases and TCM diagnosis ........................................................................................... 45
Summary for mind and emotions ....................................................................................................... 47
Mindfulness............................................................................................................................................. 48
Mind and emotions of the acupuncturist ........................................................................................... 49
Aspects for therapy ............................................................................................................................. 50
Summary for mindfulness ................................................................................................................... 54
Discussion................................................................................................................................................ 56
Bibliography ................................................................................................................................................ 57
Appendix 1 .................................................................................................................................................. 60
Conclusions
The central question I attempt to answer is:
What do we need to consider when treating patients regarding their- and our own minds?
This resulted in a discussion about the mind, the relation with emotions and the body. Additional
context was provided by relating these concepts to health and disease, Jing-Qi-Shen and mindfulness.
The mind and emotions play a central part in TCM. The concept of Mind or Shen comprises both
cognition and emotions. Emotions are related to Qi and the Qi mechanism, making a link with Blood
and stagnation pattern. Furthermore the Mind in TCM is seen as the integrative (and coherent)
functioning of its 5 different aspects, Hun, Po, Yi, Zhi and Shen, with the Heart as their conductor. Each
of these is related to specific emotions and virtues. Their normal and appropriate expression is seen as
healthy with regards to cultivating your Shen and cultivating your personal virtues (De). By looking at
the tree treasures Jing-Qi-Shen we see that emotions and the Qi mechanism literally have a central role
herein. Also blood, as it is closely related to Jing-Qi-Shen, has a determining role in disturbances of the
mind.
Normall e otio s a e t pathologi al. They are there to help us process and respond to everything that
happens in our environment. What makes emotions harmful is their duration, intensity and impaired
expression. Meaning, expressed too little or too much, or expressed inappropriately with regards to the
context. What makes emotions unique in TCM is their interdependent role with their corresponding
organs. At the core of emotional imbalances lies a destructive relationship with these (corresponding)
organs: Emotions cause stagnation, this impairs organ function, leading to an emotional response. There
disruptive effect is t limited to their corresponding organ. But we can use the specific symptoms for
information about the organs involved. The impaired movement of Qi caused by emotions (anger makes
Qi rise, giving headaches and tinnitus etc.) and the behavioral aspect of the emotion (observing Shen,
listening etc. ) both provide diagnostic insights. They provide additional information next to the standard
methods of interrogation with the Ba Gang.
Before becoming pathological emotions have positive effects as well. Or rather they have their root in a
positive aspect or Virtue. Paying attention to this in therapy can provide the practitioner with valuable
insights and a point on the horizon to work towards. Amongst others this is dependent on the
mindfulness of the practitioner. Looking at the positive aspects of emotions, the quality that underlies
them, it is possible to try and use other emotions and behaviors to overcome a pathological one. This
can be done via the controlling cycle in the Wu Xing, or using opposing emotions to counteract an excess
one.
In treatment it is important to focus on the Shen aspect of a person and their illness. A focus on the
affliction or the body can lead to affirmation of that part and will hinder recovery. To become skilled in
such a feature you have to train yourself to be both sensitive and consequent in your subjective
interpretation. Examples of consequent practices are given, and at their core is objectifying your
interpretations by e.g. writing them down, checking them via motoric responses or to training yourself
to go with the first (Shen) impression. Techniques like meditation, Qi Gong and concepts like Yang
Sheng are helpful in focusing your mind and keeping your Heart empty to accommodate a state of
empathy and helping your patients. Awareness in these matters is important for awareness and
prevention of disease.
Because emotions are related to memory and intelligence it is important for practice to explain and
discuss about the emotions with your patients. It helps with gaining insight with their life and possibly
this aids or alleviates emotional blockages without administering acupuncture. T
Health in general is reflected by a state of movement with requires continuous growth and adaptation.
This emphasizes the severity of stagnation in TCM. Mental health is thought to be maintained or
a ui ed via a moderate life style, free from desires and attachments and living in harmony with
nature. Whilst our society has become so complex harmony has become a relative notion compared to
the time when TCM classics were written. In therapy it is important to first help an individual within
their own environment and later put them (and their affliction) in the context of harmony with the
macrocosm as much as possible. The ability to recover from mental disturbances is dependent on the
constitution (Jing) of an individual, the duration and severity of the condition. What frequently comes
back in literature is the strong emphases on prevention of disease. Concluding it can be said that it
helpful to explain to patients what this means to them, and give them tools directed towards this.
At the root of mental emotional disturbances lie behavioral aspects for the greater part. The question
then is why there is such a large occurrence of these afflictions, when you assume behavioral means
reversible. Part of it lies in the overwhelming and distracting effect of emotions. Another part is that we
pursue too much the ambitions of the Heart and are too little concerned with nourishing our life (Yang
Sheng). Pu sui g Ya g he g is about finding your true nature and Virtues. Relating to these Virtues is
said to lay at the core of longevity and health. Together with reduction of desire there is no room for
distractions that will lead to destructive and unhealthy behavior and choices. It is this notion that we
should take with us in therapy, to educate people about true health and prevention of disease. This
would, on my part, be a good point for further research. The true wonder seems to take in all this
ancient knowledge and apply it to this day and age.
Foreword
My road towards TCM (Traditional Chinese Medicine) began with a fascination for Asian movies, martial
arts, meditation and Yoga. One of the most impressionable moments came at the age of 20. This was
with the head teacher of the Wing Chun Kung Fu school at which I practiced at the time. The theme he
enlivens en brings across to his students is:
Co t ol ou e otio s, o the
Now the interesting thing with a theo
ill o t ol ou
is that ou thi k ou e got it, ut eall , ou do t. And you
only learn this by virtue of the skills of your teacher. And in this particular case where the teacher is a
Kung Fu master, the point came across vividly, rapidly and painfully... Once you get scared, you tense up,
once you tense up your ability to move drastically decreases. I.e. in matters of speed and reach. That by
itself is not at all a good situation to be in. Especially in facing a skilled martial artist who then uses your
would be weapons (i.e. arms, legs or whatever) as levers that hurt yourself.
The interesting thing with martial arts is that philosophy and practicality are joined hand by hand. And
with many repeated cycles of learning, trying and evaluating it was a very fruitful builder of experience.
And if nothing else I learned that trough thought (philosophy) and experience you can create, construct,
build and survive. To me it proved that there was something very right with the Asia
a of thi ki g.
For the larger part of the modern Western world we have created our own city like habitats. Arguably
o e dista t f o
atu e tha
efo e. But i a
ase
e as a people ge e all do t ha e to
about dying from a cold, fighting with panthers, infections, lack of food etc. All thanks to how our society
has evolved in to its current state.
But with that evolution also came a complex lifestyle that exerts a lot of strain on our minds. The
components that cause this strain can of course be debated. But generally speaking the complexity of
social, financial and political structures, the haste that comes with the jobs we do, they all lay a ground
work for pathological developments. These factors are particularly unfavorable for a healthy mind and
(emotional) life. Which can cause disease by itself but moreover this causes people to act and make
decisions that will harm them either directly, or indirectly in the long term. Leading to what are ironically
alled:
elfa e diseases . He e I
efe i g to
ode
diseases like: diabetes, blood vessel and heart
disease, auto immune disorders, obesity etc. In this context people, or arguably their emotions, have
caused a restriction their movement and their capability to live their life in a satisfactory way. Please
note that this comprises both a mental as well a physical restriction. At this point I emphasize the
importance in TCM and Chinese philosophy of free flow and unrestricted movement of energy. As we
will see later this is an important part in TCM in dealing with the mind and the emotions.
Sly and deeply imprinted in our minds it is not easy to discover the workings of our emotions, let alone
the workings of our mind. Surely the latter is not the scope for this thesis. Though many philosophical
terms and theories will be reported and described in it. Being in an emotional state prevents you from
seei g thi gs lea l , i ludi g these e otio s! It s is a
ist o fog to ou
i d. A highl i o i
situation, which is hard to resolve. To quote the famous soccer player Johan Cruijf:
Je gaat het pas zie als je het doo he t.
You ill see it he
ou figu e it out
To that end we need teachers and practitioners who can help us understand and cope with our
emotions, and their pathological manifestations. I think TCM, and acupuncture especially, is a very
appropriate tool to do so. On one end it is an integrated approach that does t disti guish et ee
mind and body. And on the other hand it is stooled on an ancient tradition and framework that allows us
to communicate its essence to all to benefit from it. I especially hope that my work will contribute to a
bridging of worlds. And hopefully it will also contribute to healthcare in general as there is a need for us
all to look beyond what mystifies our minds. In all the above I found the subject for my thesis: The mind
in the use of acupuncture.
Now that communication is mentioned I plead that we as TCM practitioners are very careful with the
use of the words: Holistic and Alternative. As it is with Chinese words and concepts the perceived
meaning of a word can be something quite different than was originally intended. The term holistic has
many associations that go with it, and not all good. It is a term used by many and its original meaning is
lost due to inflation of use in the public debate. In
opi io this
o d does t do justi e to the
profoundness of TCM. To that end it is better to use the word Integrated instead. The same line of
reasoning holds for the word alternative. Maybe it is even more illustrative, as it is a word often used for
something that is tried in second place. A ranking not suitable for a healthcare system that can prevent
people from becoming seriously ill, and prevent the large scale of invasive and expensive treatments
needed such as surgery, chemo, transplantation, immunotherapy transfusion, dialysis etc. Note that
these are great accomplishments of modern medical science. But the priority should be to prevent
people from becoming this sick. If this still occurs to than use these kinds of treatment. For this to chime
within the public domain a shift of thinking needs to take place. For that to happen we need to facilitate
trust, understanding and a pure and honest dialogue. All of which can be nurtured through a properly
functioning mind and a peaceful heart.
To finalize, we need skillful teachers to help our patients and people develop and grow in their lives. For
people to become and stay healthy. In studying the intriguing and complex field of TCM I have found
myself lost many a time. Lost in translation, lost between two worlds lost within the scope of it all. Here
I am humbly reminded by a quote made by Bruce Lee in the movie: Enter the Dragon:
It is like ou fi ge poi ti g at the
do t concentrate at ou fi ge o
ou ll
oo ,
iss all that heavenly glo
Thus I hope my teachers will guide me in this process as I go along and help put the energy and focus in
proper use. I thank all of you who have helped shaping my thoughts in these, one way or the other. And
everyone who has given me the support in all of this, my sincere thanks.
Preface - Methods
In order to have a clear discussion we need to accurately define some key concepts. To that end the
TCM concepts of Mind, Disorder (i.e. disease), and Emotions are put into view. The emotions are added
here because of their close and intertwined relationship with the Mind. I aimed to be consequent with
the words: health, wellbeing, mind and Spirit. To start with health and wellbeing, basically they have a
similar meaning. Health perhaps denotes a more physical state, whereas wellbeing hints more towards
the addition of a social and/or mental component. Mind and Spirit also have a close relation. Mind (with
capital, the TCM version) is a translation of Shen i.e. Spirit. Furthermore I use capitals for TCM words
and concepts.
There are several reasons for focusing on the mind. Firstly, in TCM the Mind is a very interesting concept
by itself, its relation in Jing Qi Shen (mind) is fascinating and will also be discussed to better
understand how it is defined in TCM. Secondly, in the west we tend to see the mind as a control room,
when we know how to operate it, people can function properly and be healthy. But what do we really
know about operating the control room? (Please note that in the TCM concept of the mind also
incorporates the intellectual properties.) Thirdly, in the TCM view of the mind there is a strong
relationship with emotions. Rendering it very promising to cure and help people understand their own
problems and pathologies. Finally understanding the Mind and the emotions can help us understand our
own place within society and the universe as a whole.
The main goal a therapist has is to help people get well. In doing so ou appeal to the od s atu al
capability to heal itself. For that reason and the reasons given above, in this work I will try and answer
this question:
To that end there is an emphasis on health and disease, what are they?, how are they related to- and
described in TCM? Then these descriptions lead to the discussion on the mind and emotions, and again
the question is what is the mind? What are emotions? Etc. To add additional context to this large subject
I chose to relate the above subjects to Jing-Qi-Shen, whenever possible or relevant. I hope this will
provide myself and the reader with an interesting and traditional framework. However please note that
that the Jing-Qi-Shen framework itself is not the main subject of investigation. I assume the reader has a
basic notion of this concept and so I have introduced this subject serving to clarify the mind and
emotions.
It is also good to
e tio
hat is ot dis ussed o ela o ated o . Fi st of all this is t
ea t to e a
complete literary review. With such a large subject there will inherently be matters that are not
complete or unknown to me. Secondly I do not intend to explore the mechanisms of the mind
technically. My aim is to have a complete feel of the mental and emotional aspects of TCM and
acupuncture. It is deli e atel
ot alled the o ki gs of the
i d or something like that. This means
there is more emphases on mindfulness and less on diseases, patterns and symptoms.
Thirdly this work should be seen as a presentation and selection of publications that are relevant to my
opinion. They are selected to work towards a constructive view on the topic at hand. In the end it is a
compromise between what I have learned so far and the selection of cited works. The aim is to write it
in such a way that there can be a thorough framework for myself and perhaps others to work on this
subject. And furthermore that it is written in such a way that leaves room for additional views and
comments.
Finally this work is written for my peers in the field of Chinese Medicine. However that does not mean
that it ould t o should t e ead
people that do t ha e this a kg ou d. O e of the aspects why I
love this study so much is that, though complicated by its depth and fastness, the essential ideas are
basic and fairly easy to understand. I sincerely hope that you will enjoy reading this thesis.
10
Introduction
Choices related to our environment
What s intriguing about today is the vast amount of information and choices we have at our disposal. At
first thought may seem strange that p o le s i ge e al still e ist. Why, with so many smart people
and high end technology, solutions must be readily at hand for nearly any dilemma. Take for instance
the problem of people living in hunger. Worldwide we produce more than enough food, but for some
easo it does t get to all people. Let s elate this to the (emotional) health of an individual in this
example. There is enough energy (food) for healthy living and a properly functioning mind, but
somehow it is compromised (not evenly distributed amongst people). Too much energy is used up by
disease or stagnation1, the organs get affected and the mind suffers, see Figure 1:
Disruption of Shen
Stagnation of
Qi/Blood
(Damp and Plegm)
Disruption of
Zang Fu
Figure 1: The Shen (mind) and the Zang Fu (organs) can influence each other. I.e. to function properly a harmonious
relationship between the two is necessary. Stagnation can negatively influence this relationship.
From Yoga2 and the Qing Bai academy3 I was told that that the energy used up by disease, stagnation or
pathogens, burns people up, like a burnout. This basically comes down to a waste of energy, which we
can also represent by a traffic jam, Figure 24:
Mea i g the a tual e e g it osts i te

disease.
2
Mr. Anil, yoga teacher, unlimitedhealth.nl
3
(Jie, 2012)
4
a) archief.carros.nl , b) dvhn.nl
s of p odu i g pathoge s, as ell as the odies st uggle agai st
11
a)
b)
Figure 2, a) An event can cause a drastic increase in flow, when the flow is higher than the capacity a jam occurs. This way
transport is very in-efficient. You could see at as an overstated investment to be somewhere. But do you need to be there?
Right now you cannot know or investigate because you cannot move. A therapist can first alleviate the stagnation and ask
the uestion, whe e do eally want/need to e? Than pe haps one ould ask, how to do that, and at what ost )
pathogens like damp or phlegm can block your view on the road at hand, as such it is important for a therapist to address
this early on in the treatment.
Now where to go with this information? Do we solve this problem by managing the traffic top down and
externally seen from the environment? Or do we look at the situation and motivation of the individual?
In other words do we look at the macrocosm or the microcosm?
The answer is most likely both. As practitioners of TCM we study and follow teachings from ancient
times. Passed on from people who had a thorough understanding of the various aspects of leading a
harmonious life. Meaning to rest, feed, clothe, move and behave appropriately and in accordance with
the changing seasons and thus nature.
In treatment you obviously look at your patient s o ditio a d s pto s, but his or her health
situation is always related to their personal environment. How well are you able to live your life and
function in it? A therapists always has to consider the patient in the context of their own life s. In the
ancient texts where the relation of man and his environment are discussed there was a more direct link
between the individual and their surroundings, mostly nature (macrocosm).Nowadays our personal
environments are most often artificial and much more hectic, this is an important difference.
Surroundings and environment both refer to the same principles, which are quite broad:
Surroundings
macrocosm:
Personal environments:
individual environments:
atu e, li ati fa to s, e e ts , pla eta

social interactions, city, home, etc.
mind body and soul of an individual5
o e e ts, et .
Basically our personal environment in put between our microcosm and the macrocosm, perhaps like a
filter, or a wall if you will, see Figure 3:
Pa ado i all the soul he
of a pe so is a
a ifestatio of the hea e l Ya g e e g
fo
the
a o os .
12
Nature
(Macrocosm)
Personal /
artificial
environment
Individual
(Microcosm)
Figure 3, our environment is more artificial and further from nature nowadays compared to when TCM text were written. Is
the personal environment still in line with nature? Please note that the personal environment refers to the social interaction
between people, as well a life style
The arrow in Figure 3 in some sense represents the Taoist notion of Dao (The Way), is your path
artificially tilted or blocked by your actions and choices and emotions? Are your actions in accordance
with the Dao? And what does that mean, in accordance with the Dao? In the Dao de Jing harmonizing
with the Dao comes back to conducting yourself in such a way that you can express your own nature,
strengths and personality, spontaneously6.
Modern life (artificial in the figure) can divert this line, by too much overstimulation, stress, artificial
living environment bad dietary habits etc. The next part from the Te-Tao Ching7 can add some
philosophical guidance to this:
Act without acting,
Serve without concern for affairs,
Find flavor in what has no flavor
As I interpret this quote, it does t ea ou should t ef ai f o taki g a tio , but be natural with it.
Do t let ou o e s affe t ou a ti ities. A d look fo the jo of si ple atte s. A t ithout a ti g
refers to the concept of Wuwei. Serve without concern, to me refers to a focus on what is right, not to
worry about the out o e of o e s a tio s. The last state e t a out fi di g fla o has a lot of depth to
in. More than I can comment on here, but it seems to speak for itself. As we will see later in the chapter
Summary for mind and emotions
6
7
(Rossi, 2007, p. 4)
(Henricks, 1989, p. 148)
13
It can be said that the concept of health embodies the capability to react, change an respond according
to the circumstances at hand. These can be social or psychological events as well as the changing
environment as it normally occurs in nature.
Emotions disrupt the Qi mechanism leading to stagnation. Although they are correlated to specific
organs their disruptive effect is not limited to a single organ. Specific symptoms can be deduced from
organ relations, Qi movement impairment by the emotions (anger makes Qi rise, giving headaches and
tinnitus etc.) and the behavioral aspect of the emotion. Qi stagnation can lead to stagnation and
defi ie
of Blood, aki g that the he a t eside there and mental emotional problems can arise.
In the end all emotions will affect the Heart, when the Heart is disturbed it loses its ability to orchestrate
all the different aspects of the mind (Wu Shen, five spirits) coherently and this lead to mental emotional
disturbance as well.
Emotions have a bad PR so to say, but they do have a function, both from a western perspective as in
TCM. Looking at the five virtues (aspects of the five shen) can help guide a negative emotion into a
positive trait. And these virtues can provide a guides of where we need to go to in therapy and life as
well.
It is crucial to be compassionate and mindful for the patient you are working with, interpreting their
emotions can also interfere with yours. Are you merely observing or also projecting and reflecting? To
this end it can be helpful to incorporate techniques and manners which will allow you to objective your
own (subjective) practice. That is of course besides knowing about the different aspects and emotions as
they are described in TCM, knowing these will also help finding out what is going in with your patient on
a Shen level.
In this chapter, mind refers both to memory (in the West) and an integration of the five psyches in TCM.
It is natural to express emotions and this should be done so in a balanced fashion, not too little, not too
much. When however you are working with your patient on an emotional level you should always take
into consideration the fact that they cannot directly understand and/or control their emotions. An
intellectual understanding of how the mind works, and techniques (meditation) to redirect emotional
outes i thei ai s a help the pe so a d thei t eat e t. Thus it is i po ta t to k o e otio s
diagnostically (and correlate them accordingly to therapy).
In treatment it is important that you adopt to a method that allows you to objectify the subjective
interpretations you make. This can be by means of a journal, first impression (not overthinking), by an
understanding of emotional expression patterns and many other possible techniques.
14
Mindfulness cultivating such properties is facilitated by undertaking mind clearing and relaxing exercises
and adopting to activities that will allow you to remember your heavenly virtues.
I do t thi k it is realistic to have the same standards for living in harmony with nature as thousands of
years ago. Times have changed, and so have our surroundings. For one we have developed a mostly
urban habitat and different For a lot of people the choice is simply not there. In practice this means you
need to look at two different aspects of health concerning your patient. One is helping people to
function in their personal environment. And second is to compare their personal environment to the
ways of the macrocosm.
Though we never forget the macrocosm we have to be realistic about the world we live in, as therapists
we also need to look at the workings of the microcosm in ourselves and our patients. You could say: the
answer lies within ourselves. Addressing the internal problems (disharmony in emotions, stagnation etc.)
could result in making changes in our (personal) environment. I the e d ou do t fo us either on
micro- or on macrocosm8. Rather in TCM we emphasize individuals to live in harmony with their
surroundings.
Emotionally this means we can help people go through blockages and they will learn more about
themselves, hopefully leading to a more healthy and constructive life and lifestyle. As therapist we can
help people with this by educating them about signs, symptoms and also healthy life style habits. And of
course by treatment of a disease, which quite possible is capable of disturbing this process.
Coming back to the decision making, when you are not in balance, you ask the questions to yourself, but
you have the wrong advisors. From a Western standpoint your emotions have to functionally guide your
behavior. For example when you are attacked, it best not to try and have a theoretical debate with a
python or a lion. But to be scared a d to eithe fight o flight . Though very much simplified it is the
crux of what emotions are to do. To guide you in appropriate behavior for a certain context. Not all of
the emotions correlate so nicely as the emotion of fear to the fight or flight behavior. The point to make
here is that in case of a pathology emotions can cloud your judgment and decision making. And because
of those combined properties emotions tend to reinforce their selves. Making it difficult to solve, thus
important for us to recognize and treat.
Summarizing so far the mind and emotions are interesting to discuss because they are closely related to
physical wellbeing in TCM. As such these teachings provide a valuable insight to people in the West
because they can learn how their complaints are related to them. This makes for that people learn more
about their selves and can grow, physically, emotionally and spiritually. Furthermore emotions are a
pivot between people and their surroundings an health mental state makes for healthy choices.
By looking in an holistically at our patients, their welfare is always related to their surroundings. Those
surroundings are different compared to the time when the TCM classics were written. Therefore we
8
I have used the term macro os athe loosel he e. I a a e that i a ie t te t this as likel to ha e a o e
Daoistic meaning compared to the mundane matters to which I relate it. Nevertheless we still need to cope with
life as it p ese ts itself to us. A gua l e do t ha e the same choice of environment a the ancients did.
15
need to both create balance within the personal environment, and compare that to the ways of nature.
Resulting in a synergy, an happy and emotionally healthy person will make constructive and positive
decisions for him or herself (and their surroundings). Or in Daoistic terms, living in harmony with the
Dao harbors traits and behaviors which support the effortless expression of yourself (talents, strengths,
et . hi h is the ulti ate i tue, De.
In the next chapters the Mind and Emotions will be outlined in more detail and the subject of health and
disease will be put into more context starting with Jing-Qi-Shen and following up with a more general
discussion on these subjects.
Jing-Qi-Shen and wellbeing
In the previous chapter health is related to living in harmo
ith the Dao i su h a a that o e s
virtues are effortlessly harvested and displayed. Jing-Qi-Shen provide an interesting framework to relate
health too. I
ot st et hi g the i agi atio
stati g that the o te po a
otio of od -mindsoul are rooted in Jing-Qi-Shen. Their health is mainly determined by their preservation, and balanced
presence in the body.
Jing-Qi-Shen are also known as the three treasures, highlighting their importance. It reflects the position
of humans between heaven and earth. And in ourselves it links mind and body to each other. A very
important distinction from Western medicine where body and mind are considered more separately.
You can relate to this concept in many ways, and on many levels. Below is a simple overview to denote
its broad scope in Table 1:
Table 1, overview of various aspects of Jing Qi and Shen.
Level
Up
Middle
Down
Cosmos
Heaven
Man
Earth
Vital Substance
Shen
Qi
Jing
Organ
Heart
Spleen
Kidney
Clinical
Keep empty
Maintain flow
Prevent loss
Comment
Etherical/mind9
Material/body/basis10
Maciocia11 describes it as follows:

Essence is the material basis of Qi and Mind, forming the foundation for a happy and balanced metal
and emotional life
The fact that Jing-Qi-Shen are called the three treasures, reflects their importance in TCM and in health.
Of these three, Jing is the physical side, where Shen it the more etherical side. Qi is in between in
density and function, you could say it facilitates the transformation from one to the other. In that sense
the Qi mechanism is crucial in a healthy emotional life, as emotions have an effect in Qi. This is also
99
Consciousness, pure connection to the macrocosm. (Saraswati, 2012)

Di g Li, u shaka le asis, elated to a feeli g that ou a t go o g a d ei g i
11
(Maciocia, The Foundations of Chinese Medicine, 2005, p. 242)
10
o t ol. (Saraswati, 2012)
16
efe ed to as: the spi itual a is

the Spleen, and earth organ.
12
. It is also interesting to see that in humans correlate to Qi as well as
What is important to take from these relations is the notion that man stands between heaven and earth.
Or in other words man is the representation of heaven on earth. The philosophical implications of this
trinity are many. But here I want to use this framework for two reasons. Firstly it gives a proper
reference to what we now label traditional in TCM. As such it is a good reminder to where we come
from in TCM. Secondly it is a framework for thought. An alchemic and more spiritual concept of Jing-QiShen is that life s pu pose is to t a sfe Ji g i to he . Ho
a ou t a sfo
a d ulti ate ou
physical or pre natal self in such a way you harvest all your talents. This goes from an earthy
acceptance of yourself (and your situation) to a profound wisdom. Where Jing recedes as we age, Shen
increases13 over time, see Figure 1:
Figure 4, As Jing (the sand) decreases over time the Shen (empty space) increases. A transition from
shape to function. According to Daoist sources this is an important feat to try and accomplish during life.
How is the bodily Jing transformed into heavenly Shen14? Via Qi, which is nicely
positioned in the middle of Jing and Shen. What is clinically vital regarding Qi?
Maintaining a free flow. This is where emotions also come in to play. Emotions are
manifestations of Qi and they can cause blockages and hindrances in free flow of
energy.
In a different biological sense this is what happens when we regard the transformation from DNA (which
interestingly can be regarded as Jing15) into molecules (enzymes) that perform functions, which let you
li e ega di g DNA as a fo of Ji g gi es it li i all si ila properties in TCM as in Western Science.
I the latte o e s life spa is dete i ed
the slo deg adatio of DNA. A d it is eas fo us to
imagine that quality of your DNA relates to the quality of life (i.e. health). Hence it is important to
prevent damage to it. Like with Jing if you rest appropriately you can recover from damage done.
Harvesting Jing and preventing DNA damage in this sense are similar concepts to longevity and quality of
life.
In TCM we both diagnose and treat patients by looking at what their conditions of Jing-Qi-Shen are. Jing
set the a kg ou d of a pe so s health. Is it ell p ese ed, hat is the o stitutio a d hat phase of
life is he or she in. Of the three, Qi and Shen pertain to more to this thesis. In diagnosis it is these two
we are most concerned with, and as we will see later it is wise to be guided or directed toward a focus
on the Shen in treatment.
To recapitulate, Jing-Qi-Shen gives a broad basis for the concept of (mental) health. It positions man
between heaven and earth and suggests a transformation from Jing to Shen under the influence of the
12

Qing Bai 2012 (Saraswati, 2012)
14
Bodily and heavenly also refer to negative and positive habits like for example desire and compassion
respectively.
15
Dr. Wang, course on channel palpitation, Dublin 2012
13
17
free flow of Qi. As a free flow of Qi is also under the influence of the emotions (and their relative
expression, this concept steers in the direction of emotions being an integral part in achieving your
li es goals a d at the sa e ti e ei g health . The latte is a t o a st eet, ou eed to e ph si all
healthy enough to be mobile and discover your virtues (De from the Dao de Jing).
From a treatment perspective Jing provides the starting point and quite literally the context of working
with your patient. Normally a TCM practitioner will be drawn toward the realm of Qi and Shen. As we
will see later, it is the Shen that should guide us for optimal results.
In the next chapter all of the above is related to the modern concept of mental health.
18
Health
Health is a central theme in our modern life, and the healthcare industry is a major investment for
ou t ies i the West. We fi d health i po ta t that u h is lea . But ou u e t u de sta di g of it
is largely based on physical Newtonian though. Leading to a pursuit of identifiable targets (enemies) that
are thought to diminish are life e pe ta ies. Ide tifia le ea i g, if ou do t see it, it does t e ist.
U fo tu atel this lea es the pu li opi io i a state he e faith o t uth is dete i ed
eithe
how well we are able to experiment or how well we are at marketing. It is true that is difficult opposing
a ti e f a e, o zeitgeist. I as told o e that e e Ei stei s theo of elati it as eje ted laughi gl
his pee s at fi st. The e pe i e ts a d athe ati s e e sou d, ut the ould t i agi e it e e
true.
Do t
istake the a se e of e ide e fo the e ide e of a se e
The definition for health coming from the WHO is as follows:

Health is a state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity16.
It is interesting to see that two out of three parameters are non-physical. That this is important is
efle ted
the latte pa t: health is t just defi ed
the a se e of a [diag osa le] disease. E e
more interesting is the relation that is made to social well-being. This opens the door to the definition as
we have learned in TCM.
Beautiful elaborations on health can be found in the classics of TCM. A very nice quote on health and
wellbeing from the Neijing Suwen17 goes as follows:
Health a d ell-bei g a e a hie ed o l
e ai i g e te ed ith o es spi it, gua di g agai st
s ua de i g o es e e g , ai tai i g o sta t flo of o es i a d lood, adapti g to the ha gi g
seaso al a d ea l a o os i i flue es, a d ou ishi g o es self p e e ti el .
We can deduce from this passage that Spirit, energy conservation, absence of stasis (of Qi and Blood),
living in harmony with nature and nourishment are key elements in health preservation. A centered
Spirit is named firstly, probably with good reason. Though I must admit that this part remains illusive to
me. My guess would be a spirit that is focused, with meditative qualities to ad to it. A healthy Spirit will
grant you the wisdom, not to squander your energy, to work on blockages, to adapt to the
circumstances at hand and to nourish yourself before your burn out. I will address the Spirit, but also the
stagnation of Qi and later.
I a a this has also to do ith ot losi g e e g , ut I do t thi k it is uite the sa e as is meant in the
quote above. Squandering energy and nourishing oneself, will only come back in this thesis indirectly,
meaning as the product of a healthy mind.
16
17
http://www.who.int/about/definition/en/print.html
(Ni, 1995, p. 265)
19
An interesting perspective on life, based on the Su Wen chapter 17, comes from Elisabeth Rochat de la
Vallee18. It concerns more the view of the therapist:
Life is not the constant regulation of something that is always the same. Life is always adaptation and
transformation
To me it is quite interesting. I ould t sa that e do t k o this idea, but because we are tended to
look at all the details19 there is a feel like we are talking about a status quo. Something that is or is not,
yes or no. In Western science there is a term that might give some insight here, it is called the dynamic
equilibrium. More readily available examples are the homeostasis of variables in the human body like:
ph, temperature, ion concentrations etc.
The next quote contains basically the same information as the previous one, but is more relevant for
diagnosis and treatment:
A normal pulse image is not the same in each season because the manifestation of life inside the body
through Qi and Blood is not the same
Here we are reminded again that life is about change and adaptation (between birth, growth, decay and
death), this is reflected in the body as well, regarding both Blood and Qi. Finalizing this part with the
beautiful link between outer and inner.
Mental Health
In the previous chapter we already saw that mental health is incorporated already in the general and
broad definition of health. Let us elaborate on this.
Quiet peacefulness, absolute emptiness

the true Qi follows [these states].
When essence and spirit are guarded internally,
where could a disease come from?
Hence,
The mind is relaxed and one has few desires.
The heart is at peace and one is not in fear.
The physical appearance is taxed, but is not tired20
The quote above nicely reflect several key aspects regarding mental Health. Coming back to the example
of the burnout and traffic jam (Figure 2) this poem tells us how to go about getting healthy: emptiness.
Getting rid of all that is unnecessary and thus (possibly) harmful.
18
(Larre & Rochat de la Valle, The Seven Emotions, 2005, p. p. 51)

I the o te t of Weste
Ne to ia thought a d Easte
holisti thought. The fi st has a fo us o pa ti les
and details. Whereas the latter emphasizes a more of a global form of understanding.
20
(Unchuld, 2011, p. 34)
19
20
Naturally there is no difference between health in general and mental health. Likely it is the unique
coupling of Mind and Body (discussed in Jing-Qi-Shen and wellbeing) that makes no difference in Mind
and Body, both can affect each other, reflected in the body by Xue, Qi and mental wellbeing, from the
Ling Shu21:
when he Qi of the five Zang is peaceful and stable, the Xue and Qi in the channels are in harmony and
s ooth, the he ill e ell e ai ed
At this point it is o th hile to e phasize the Buddhist otio : The i d is ela ed a d o e has fe
desi es . I Buddhis it is thought that all suffe i g has its oot i desi e. A d f eei g yourself from this
brings you to enlightenment. This is different way of interpreting the control of your emotions.
Finalizing remarks concerning health: Later we will see that desires come from a wrong pursuit of things
given in by the disturbing effect from our emotions. So it is not to say that we o t have emotions or
desires, but the ones we do have will be a reflection of our true nature. This is why controlling our
emotions and/or your desires put you in a direct way (or Tao) towards your destiny (Virtue or De).
Which enables p ope ulti atio of he , o e e e i g our heavenly nature.
With regards to observing mental health it can be said that it is reflected by bright eyes, clear use of
words, a beautiful complexion and a regular breath. Vitality is to be seen in the Shen of their eyes22.
21
22
(Jie, 2012, p. 5)
(Rossi, 2007, p. 66)
21
Disease
The basic premise of disease in TCM is not to be in harmony with your surroundings. This can originate
from the outside described by the term Ji, Qi attacking the person from outside (environmental
factors), or can originate from the inside, described by the more commonly used term Bing:
a
o e se e e a d o ple disease, that is atta hed to a pe so s ighteous Qi i side the od
Fruehauf ela o ates: o the

that:
ost literal le el Bi g
ea s affli tio of the hea t a d su
a situation where so e od has e o e ph si all ill due to
23
a izes to sa
e tal, e otio al, o spi itual auses
And to relating disease to the tree treasures, it is the scarcity of Jing, deficiency of Qi and weakness of
Shen that causes disease24.
To recapitulate here are the basic definitions causes of disease in TCM25,26:
-
Internal causes of disease (emotions)

External causes of disease (six environmental factors)
Miscellaneous causes of disease
Obviously a disease caused by an external influence can transfer to the internal environment. The
effects of external (and miscellaneous) causes of disease are discussed indirectly. Meaning that any
disease can (and on some level will) affect the mind. But the focus will be on the direction from the
mental and emotional side.
In this context the mind is related to internal causes of disease. So the scope of this text is mostly about
the i te al . This is not surprising since having shelter from the influences of the climate, rules this out
as a cause for most part.
The good and bad of emotions
To sho tl go a k to he e e left of, o all e otio s a e t ad. The a e the e to pe fo
a
fu tio , f o a Weste s ie tifi sta dpoi t the a e ea tio s to the o ld depe de t o og iti e
interpretation, physiological activity and context. From a TCM perspective their function is subtly
described as organizational27.
Let s o side the follo i g state e t:
What actually makes an emotion harmful is either the long term presence, or their intensity28 .
23
(Fruehauf, All Disease Comes from the Heart, June 2009)

(Liren & Xioming, 1993)
25
(Maciocia, The practice of Chinese Medicine, 2008), p. 241-267
26
(Deadman, The Causes of Disease (part one), May 1981)
27
(Larre & Rochat de la Valle, The Seven Emotions, 2005, p. 26)
28
(Maciocia, The practice of Chinese Medicine, 2008, p. 278)
24
22
And their blinding or overwhelming character:

he a e otio is p ese t it is i li ed to e agge ate so ethi g29
To add to that we have the tendency to perpetuate our own mental afflictions, harboring social or
mental patterns that will reinforce the disease30. I emphasize once again the reason why understanding
emotions is so important. They can be overwhelming, intense and misleading. And it is because of this
help from someone objective is needed. A good example of this would be an drug or alcohol addict,
refusing to admit they are sick, or are having health issues, relating to their social and personal life. Or
how in our heads we can convince ourselves chocolate or French fries are healthy. Though the latter two
ight ot e all that ad I sha i g
patholog he e ith the eade combined with a strong
memory and emotion things can be become destructive. It would probably take a very specialist
approach to treat someone with these mental patters. It is not the point to elaborate on this. It is just to
say that we all can be misled by our emotions one way or the other.
What is important for treatment is that there is a nature as well as a nurture component to emotions
and behavior31. Nurture implies that learning about your emotions can or should be an integral part in
treating their related pathologies. The nature component implies that there possibly is a limited to what
extent a person can be treated for their disease. This is mainly determined by their prenatal constitution
or Jing. Conditions you are born with are quite difficult to treat, if not impossible. If this is the case one
has to consider the relief of symptoms the best possible option for therapy. Most often we will be
concerned with the postnatal effects of the minds and emotions. Treatment here is limited by the
duration and severity of the condition, both factors in the reversibility of an imbalanced state.
The aspect of context is also important in TCM when we discuss the appropriate expression of emotions.
Laughter is appropriate in situation of joy, but laughing continuously or when told someone has died can
denote a pathology related to Heart.
The main effect emotions have in pathology is that they drain Qi in general, exhaust and impair the
corresponding organ and can cause stagnation. More is discussed in the chapter: Effects of emotions on
the Qi Mechanism.
Etiology
My impression is that there is a fairly common understanding of contemporary causes for mentalemotional problems. A helpful summery is given by Maciocia32:
-
Constitution
Diet
Overwork
Excessive sexual activity33
29

(Saraswati, 2012)
31
(Linden, 2006, pp. 62, 151-155)
32
30
23
Drugs
I would like to complete this list with Sleep as it is very important for mental health and wellbeing and
cognitive functioning34,35.
If you look at the list above, four out of the five are behavioral factors. Though with drugs you could
argue it can be a choice, but your constitution can also make you susceptible to addiction. In an article
by Deadman he relates overwork to the emotions: greed. ambition, guilt and insecurity36, in part these
are further discussed in the chapter of emotions.
Lee emphasizes the importance of the digestive system in mental disorders, when the energy of the
Spleen and Stomach system is unbalanced, Shen disorders will follow, amongst others problems with
sleep. Qi stagnation in the Stomach and Large Intestine will block the ascendance of clear Yang Qi,
causing forgetfulness37. In reference to Jing-Qi-Shen, humans are related to Qi, and the corresponding
organ is the Spleen.
At this point it is good to mention that diet o t e dis ussed e o d this point. To me it is subordinate
in the discussion on the mind and emotions. Pathologies in diet are to extent related too emotions
(craving, or so called emotional eaters) and choice, which lead me to focus on the mind and emotions
instead of diet itself.
In the West we have many complicated theories on the workings of the minds, disease and pathology.
How adapt can a theory be that you would be able to summarize it in a single sentence:
Patholog is just a e ess o la k of so ethi g at the le el of the fi e Za g
38
33
It is said that with this Essence is lost. There are those who say that for this reason abstinence is beneficial to
health. Such remarks should be seen in the context of that believe or religion. In TCM this is said to cause
emptiness, which prevents you from pursuing the [true] ambitions of o e s Hea t (Larre & Rochat de la Valle,
The Seven Emotions, 2005, p. 119)
34
(Linden, 2006, p. 136)
35
(Unchuld, 2011, p. 33)
36
(Deadman, The Causes of Disease (part 2), September 1981)
37
(Jie, 2012, p. 5)
38
24
Susceptibility
Very briefly we can describe (Western medical) risk factors in the prevalence of mental disorders39:
-
Familial history (Jing, genetic)

Recent stressful event
Prior episode of depression
Presence of another mental disorder
To me these factors appear vague. Meaning from a medical standpoint what would you do with this
information? Though TCM can be illusive, in my opinion it provides a better, broader framework to put
around mental disorders.
Like with diet, these points are depicted here to have a more complete overview and I would like to
leave it at that for now.
Biomedical factors
Also a brief description in order to be complete40:
-
Thyroid disease
Degenerative (neurological) disease
Infectious disease
CFS
Drug use
Hematologic disease
Like the previous paragraph, it is good to be aware of these factors, but clinically it is difficult to extract
information of it, so I will leave it like this.
39
40
(Saraswati, 2012, p. 23)

Ibid, p. 24
25
Diagnosis
Diagnosis in TCM is based on four pillars41:
Diagnosis by:
-
Observation, seeing
Hearing and smelling
Touch (pulse, channel palpitation)
Interrogation (asking)
As we are now working within the domain of the mind, the diagnostics involved (and discussed) are
mainly seeing and asking. With seeing here it is meant the true Shen observation of a person and their
condition. With asking I mean asking about the intricacies of mind and emotion, so in that sense, in this
work we are outside of the scope of the Ba Gang.
The tricky thing with the mind and emotions is that they can deceive us, and cloud our judgment.
Further on we will see how why this is, and even later how you can train yourself for addressing this
appropriately.
41
26
Summary for health and disease

Health is governed by moderation in general, and of desires and ambitions especially.
Health and wellbeing are determined by both physical and mental-emotional factors. Furthermore a
subjective feeling of welfare is part of this as well. If live is movement and change, health is the capacity
to act espo d o adapt a o di gl . I this se se health is t a stati state ut athe a d a i
between people and their environment. In TCM it this is recognized and has led up to an emphasis on a
free flow of Qi and blood and mentally by an effortless expression of oneself.
Mental disturbances are determined by an imbalance and or inappropriate expression of emotions that
are either very intense or long lasting. Leading to impaired function on a physical (Qi and Blood
stagnation, draining of Qi) and mental level, and on a larger scale failure to fulfill o e s life a itio s
and goals (virtues or De). The road (Tao) towards discovering these virtues is different for each. What
helps is participating in rituals that help ou e o e i dful, i.e. to e e e ou hea e l atu e .
The success of treating mental and emotional afflictions is determined by constitution (Jing), the severity
and the duration of the condition. Since emotions are related to our memory and created in part by
learning, it is advisable to facilitate an intellectual understanding of the occurring pathological emotions
during therapy. From this it can be concluded that talking and getting to know your patient is important.
From this perspective the mind and emotions will be described in the next chapter.
27
Mind and emotions

W iti g this hapte I do t see to e a le to des i i g o e ithout the othe , pe haps it akes it
somewhat confusing to read, however this fits very well with the TCM idea of how related the two are.
Internal
External
Emotions
Figure 5, the emotions, let us call them effectors of the mind, help us deal with our environment in the broadest sense. As
such they are the interplay (overlap in the figure) between external and internal.
The mind is the soul, cognition, memory and emotions all integrated and working well together. In TCM
it is said that this coordination is done by virtue of the Heart. The etymology for mind is memory, in TCM
also elated to the Hea t. A d i the West e ha e the sa i g: lea i g
hea t , hat also see s to
be the line of thought from TCM point of view. You learn by Virtue of Yi (Spleen), but you truly
memorize with the virtue of your heart. Making this small circle complete. Furthermore the Mind is
thought to be consisting of 5 different parts, displaying different virtues and pathologies, one of which
just named here.
Chapter outline
All the above matters will be discussed in this chapter, starting with the mind and emotions, and
continuing with the Heart, because of its special role regarding TCM and mind and emotions. After this
the 5 emotions and virtues will be discussed in more detail, followed by an more general description of
emotions in TCM.
With the chapter Objective subjectivity I aim to bridge the knowledge gathered so far towards the next
chapter of mindfulness. The chapter explains the importance for practitioners to train their minds, and
the chapter mindfulness will elaborate on this.
The chapter is finished with a short overview of disease and diagnosis in TCM, and a summary.
28
Mind
In Chinese medicine a very distinct and profound definition of the mind is given:
that hi h is su tle a d i isi le, et o
a ds e e thi g.
Or:
the highest point where life brightly expresses itself is the spirits42
This means we have the following order in TCM:
Shen Qi Body (vessel), or:
Mind emotion Body.
So we see that the mind is foremost in TCM, and it is the ruling entity of a person.
Maciocia provides us with this beautiful quote:
The mind is a transformation of Essence and Qi: both [pre-heaven and post-heaven] essences contribute
to fo i g the i d
Furthermore he gives a helpful notion on why emotions pertain to certain organs. As he states it the
energy of an emotion is innately present in the organ, and dependent on the stimulus it will resonate
with the psychic energy of a particular organ. In the case. Thus it is emphasized that emotions are not
so ethi g that atta k us f o the outside43. Another expression of the relationship between the
micro- and the macrocosm.
The definition of mind thus is very broad and philosophical. To add to that the mind is also the faculty of
cognition, thinking and feeling. A narrower description puts the mind into two parts, cognition and
emotion44. Cog itio is t dis ussed i this thesis separately from the mind. You could argue that
cognition (true knowledge and learning) is also dependent on the emotions (and the five Shen). In this
sense maybe the division in cognition and emotion relates more to our western thoughts about the
mind than to the TCM ideas.
42

44
43
29
Emotions
The Weste te fo e otio s is ased o the Lati et olog a d ea s that hi h o es . It is
interesting to relate this to the pathological effects that emotions can have on the Qi dynamic (see
Table 5 . I Buddhis the e a e t o e ha is s k o
that a
o e the i d. The fi st is o e
cognitive, where you logically think of what to do next (based on proof). This form is suitable for
learning about your emotions and how to deal with them. The second one is a more spontaneous way of
thi ki g, a d it elates to ou fi st i p essio . The e is a s all o po e t of easo i g p ese t, ut
not so much. It is in the second group that Buddhism foresees problems with. This distinction brings
forth a term called destructive emotions. A very adapt description, it comes back in a similar form in the
paragraph Emotions and expression. It just to say that when considering aspects of the mind,
mindfulness and meditation play a big role as well (see the respective chapters). The etymology of mind
stems from memory45. The combination of a spontaneous occurrence of an emotion and memorizing it,
gives a hint of the complexity of this process. It is a worthwhile aspect to remember in treating
behavioral aspects of a disease, and therefore relevant to the mind and emotions.
Emotions in Chinese medicine are better translated as passions. This word stems from the Latin partire
which means to suffer. And this relates better to the destructive effect emotions have as a cause of
disease, corresponding to the Chinese Qing46.
The Heart
It is said the Heart is the residence of the mind, it resonates with all the different aspects of the 5 shen
and furthermore it orchestrates and regulates emotions. Besides its o
emotion Joy it is also related
to having a purpose and applying yourself. The Chi ese do t make/have a difference between Heart
and Mind. Because of this a lot of emotional symptoms we normally perhaps would discard (in Western
medicine), to Chinese are full of intellectual insights47.
Having a Heart and being human means that we dynamically balance between the earthly (bodily)
desires and the virtue of your heavenly nature. We are the only animals to walk on the earth with two
legs, bound to the earth, but upright directed to heaven to find it on earth.48 Humans as a vessel for Qi
(earth) and Shen (heaven) we can choose their own direction, they meander between the downward
movement of earth and the upward movement represented by heaven.49 Remembering your heavenly
nature is what creates room from the earthy problems, and will facilitate development of your true self.
The Hea t is the oot of life a d the o igi of the Mi d 50, and its importance in mental/emotional
afflictions is great, all emotions affect the Heart. With this is stressed the importance of the Heart as a
concept to health. To be open, understanding and connecting.
45
http://en.wikipedia.org/wiki/Mind#Etymology
47
48
49
(Maimon, 2012)
50
46
30
In contemporary TCM the Heart is generally regarded to pertain to Fire. In ancient texts though it was
ascribed to Earth. To quote:
The human condition, therefore, is metaphorically described as the state of having an earthen heart,
which in its healthy state is capable of containing the fire of spirit, including the emotions and their
pote tiall t ou leso e a ifi atio s
When regarding the Hearth as an empty container, a place where the Shen can reside, it makes sense
that is an Earth organ51, as a physical chamber to hold the Fire of the spirit. This supports the Chinese
philosophy of how man is created by clay (earth) and the fire of Heaven. The reactiveness, movement
a d fi kle ess of the Hea t is ala ed
its ea th groundness. Without this there is room for the
seven emotions to create disturbances52. Larre and Rochat describe Yi (intellect or purpose) as a raw
material, like clay, becomes fixed by the warmth of fire (Heart) giving form. When purpose remains,
there is Zhi, will.
Supposedly an earth organ, the Heart comes back in the center of Jing-Qi-Shen, as being the bodies
emperor as well as the central earth bound place to balance the fickleness of the Shen which resides
there.
Heart and blood
We know that the Shen resides in the Heart, and Heart governs blood. Shen, and thus Heart, governs all
mental activities. An important relation between Shen and Blood is:
Blood a ho s the he
Meaning Blood embraces and anchors it, creating a peaceful and happy mind. And simply stated
emptiness of (Heart) blood, will result in mental restlessness, depression, anxiety, and insomnia. Which
can in turn lead to a deficiency of blood. Symptoms reflecting this are pale complexion palpitations and
a weak or irregular pulse.
Emotionally speaking the Heart stands for the capacity to have meaningful relationships. A healthy Heart
a d i d ill o t i ute i ou a ilit to elate to othe people. This is hat akes a ope Hea t so
important. It also shows that opening up to others is what is leading in health, happiness and mental
wellbeing. Subtly supported by the Buddhist thought that all suffering is generated by attachment (i.e.
to self/ego). Another theorem that adds to this thought is that:
all disease o es f o
the Hea t
53
It is another way of saying the it is the Mind that is the most important, highest and noble faculty of
man. If there is an unbalance, unhappiness etc. they are prone to manifest as an disease.
51
Please note the previous reference on earth versus heaven, where earth is associated with craving.
As opposed to animals who are generally free from the pathological influences of emotions
53
52
31
The relation with Blood, and blood flow is crucial to the Heart and Shen. A stated before Shen resides in
the Heart, and is anchored by Blood. The three treasures are important in healthy Blood household, see
the following:
Jing
Qi
Shen
Jing
Xue
(Blood)
Qi
Shen
Transforms into blood and vice versa

forms blood
Is nourished by blood
Commander of blood/ blood is the

mother of Qi (nourishes)
Holds, moves, generates blood
Anchored by blood
Heart controls the vessels
Resides in the Heart
Figure 6, Jing-Qi and Shen are all closely related to Blood.
In TCM the Mind is closely related to the body. If essence (Jing) is flourishing, and Qi vital, the mind will
be peaceful and happy. The reverse is also true, when Jing and Qi are weak/deficient the mind will
suffer54.
As Figure 6 depicts Shen resides in the Heart, and Heart controls the vessels, by extension Shen resides
in the vessels55. I
o de i g if this elates to the iologi al effe t that where you focus your mind on,
will generate an increase in blood flow to the corresponding organ/ body structure.
A concluding remark: Blood (yin) anchors the Mind (yang). And thus for a healthy mind we need a good
production and flow of Blood. In the previous chapter the Heart was introduced as both an Earth and
Fi e o ga , ea th p o ides oo a d also a ho s the Mi d. I
ot su e ho these t o aspe ts elate
to each other. Perhaps it is by the function of the earthy organs (Spleen and Stomach) to convert Jing,
into blood. Where its formation is completed by the spark of fire (and Shen?) of the Heart.
Whe it is said the Hea t should e e pt , a e pt essel , it efe s to ei g f ee f o
emotions and obviously not empty in relation to Blood, an interesting contrast.
54
55
ha
ful

(Al-Khafaji, 1995, p. 32)
32
Aspects of the five Shen

So far we have discussed the Mind (in general), emotions and the Heart. Actually the Mind in TCM is
composed of 5 different aspects, Wu Shen. We already highlighted on the fact that an empty heart has
room to accommodate the view and presence of other people. Coming back again to health, it can be
thought of as the absence of destructive emotions and correlated behavior. If all disease comes from the
Hea t, a health Hea t should t ge e ate diseases. A tough statement to make I guess, with deep
implications. In part we will address this in this paragraph by looking at the virtues of the five Shen. Later
(in the chapter Mindfulness) we will see that health is determined both by absence of destructive
emotions and expression of true or virtuous emotions, there to express your true self.
The Heart is the emperor of the five Zang and the place where the Shen resides. The Heart Shen
determines the other four Shen56. In each respective organ the Shen embodies a different aspect:
In the liver it is Hun, in the heart it is Shen, i the splee it is Yi, i the lu g it is Po, i the kid e it is Zhi
As stated before, the mind is a transformation of essence and Qi. The relationship with the five Shen and
Jing-Qi-Shen is depicted below in Figure 757:
Jing
Qi
Shen
Zhi and Yi
Hun
Po
Figure 7, as Jing is transformed into Shen, it takes the Zhi (will power) and Yi (intellect or memory related to the heart).
From this relation it is said that Hun is close to essence but it comes and goes and Po is close to Shen,
but it comes and goes58. Related to this Hun has the ability to imagine (yang) and Po has the sensitivity,
touch of the surrounding (yin)59.
Now let us first look in more detail to 5 different aspects of the mind and how they each pertain to
specific emotions and correlating Yin organs in Table 2 below60:
56
(Jie, 2012)
58
(Larre & Rochat de la Valle, The Heart, Ling Shu chapter 8, 2004, p. 70)
59
(Maimon, 2012)
60
57
33
Table 2, components of the TCM concept of mind, related to organs and corresponding emotions. Sometimes emotions are
described as 5, or 7 (qiqing). In the latter case You and Jing are added to the list of five.
Spirit
Shen (Spirit)
Hun (Etherical soul)
Po (Etherical soul)
Yi (Intellect)
Zhi (Will power)
Organ
Heart
Liver
Lung
Spleen
Kidney
Virtue
Ecstasy
Vigor
Nostalgia
Contemplation
Awe
Emotion61
Xi (euphoria)
Nu (rage)
Bei (sadness)
Si (thought)
Kong (fear)
You (anguish)
Jing (fright)
Emotion
Joy
Anger
Grief
Worry
Fear
Emotions are numerous62, 63, however in TCM they are often described in a sets of five or seven, due to
the philosophical implications in Chinese numerology64. In another arrangement the emotions are
categorized as six, related to the six climate factors. A very suitable metaphor for the unpredictability,
intensity and vastness of emotions themselves the eathe of the i o os os 65. Or to quote from
Larre & Rochact de la Valle66:
Hea e possesses i d a d ai ,
a possesses elatio a d a ge
Nicely followed up by the statement that it is natural to have perturbations, but it is not normal to
always be in a storm or hurricane. The number five represents our virtues, they can be under attack by
attachments or over indulging in things. This in turn can lead to a more noticeable imbalance in the
seven emotions, which all together can lead in diminished health. An overview is given below.
Indulgence, attachment etc.
5 psychic
aspects
Influenced by
"7" emotions
effect towards
health and
Shen
Figure 8, the 5 psychic aspects here refer to the traits and characteristics of a person. Going through life it is the balanced
expression of these virtues that will guide you towards cultivation of your Shen. Emotions are also related to the 5 Shen, but
their long term or strong effect negatively influences health. Note that the 5 Shen (virtues in this case) can also create
67
imbalance themselves by selfish attachments or overindulgence .
61
(Rossi, 2007, p. 14)

In Buddhism it is said there are 84.000, denoting the complexity of the mind, but also the number of ways to
sta t ou path to e lighte e t . A gua l this elates to the p e iousl dis ussed o ept of Ji g-Qi-Shen.
63
(Coleman, 2007, pp. 116-117)
64
(Larre & Rochat de la Valle, The Seven Emotions, 2005)
65
66
67
(Fruehauf, All Disease Comes from the Heart, June 2009, p. 29)
62
34
The grouping of five relates more to the innate mental aspects, meaning we are all born with the traits
and characteristics relating to, Shen, Hun, Po and Yi. We have our own landscape of emotions, likes and
dislikes, which is normal. The seven emotions are considered to be the pathological counterpart of the
five virtues or five Shen. Ju-Yi calls it: post atal a ifestatio s of the i te a tio of the i di idual ith
the o ld 68. Meaning that as a person with certain traits, as you undergo life you are subject to the
influence of emotions. The relation between the five Shen and the (seven) emotions can be described as
follows: E.g. it is the Yi that accounts for once intelligence and focus and it is the excess emotion worry
(or thought) that can affect it negatively. For the others it is vigor that turns to anger, ecstasy to
hysteria, nostalgia to grief, awe to fear. Possibly leading to fire pathologies, excess, deficiency or
stagnation69.
Being exposed to life and its hurdles, interactions etc. influences your wellbeing. With influence I mean
imbalance or disease. The long term or profound effect of these influences eventually influences Shen
and the overall sense of wellbeing and happiness. In the next chapter the virtues of the five Shen will be
discussed. Focusing on these positive aspects can be an positive outlook in therapy.
68
69
(Ju-Yi & Robertson, 2008, p. 76)

35
Virtues of the 5 shen

As stated in the previous paragraph, the five aspects of Shen relate to the innate state of an healthy
human being. In TCM they are also called the Wu Chang (five virtues) The balanced ability to express or
perform these traits is what determines health. In therapy, by talking and observing you can get a feel
for what is going well for someone, or where they could be lacking. Knowing about the five virtues can
help with a compassionate understanding for your patient and so enhance the effectiveness of
treatment.
The table below summarizes the five psychic aspects, with some typical characteristics one can look out
for:
Table 3, five psychic aspects and their characteristics.
Mind
Corporeal soul (po)
Organ
Lung
Characteristic70
Tenacity, physical appearance
Intent, reflection (yi)
Spleen
Organized logical thought
Spirit (shen)
Heart
Spark of intelligence, recognition
Essence (jing) / Will (zhi)
Kidney
Ability to finalize intended action
Ethereal soul
Liver
Balanced courage
Another overview is given by Fruehauf71, in it are more mental aspects compared to the previous table:
Table 4, different positives aspects of the 5 Shen.
Organ
Virtue
Positive
quality
Powers
Wood
Liver
Compassion
Sense of
direction and
strategy
Containment
Fire
Heart
Propriety
Understanding,
sacred
connection
Respect
Earth
Spleen
Integrity
Trust and
reliability
Commitment
Metal
Lung
Selflessness
Radiance of
sound and
light
Discernment
Water
Kidney
Wisdom
Soft and
harmonious
Awareness
It is remarkable to see the difference in these two tables, coming from different references. Table 3 to
me has a more basic quality to the properties it depicts. Table 4 depicts more of the qualities in life, and
to my opinion reflects the idea of virtues (De) the best because it can provide an outlook on personal
development and growth.
Foreseeing the chapter on Mindfulness the water element in both tables is interesting to highlight. In
the tables it is related to following through with your actions and wisdom. Larre and Rochat describe Zhi
as:
70
71

36
I
oth o fused a d i t igued
the fa t that the ood ele e t is elated to o passio . I
Buddhism and contemporary ideas of mindfulness compassion is related to the Heart. Maybe it has to
do with the relation (and control of) anger. Perhaps it is though that controlling your anger towards
others has to do with being compassionate towards them.
There are also helpful traits to be found with regard to the elements themselves72:
-
Water, fear. But also the flexibility to withstand and go through difficult situations
Wood, anger. But also patience (like a slowly growing tree), or the drive to push through
Fire, joy. The negative emotion could be madness, a form of isolation perhaps. But fire also
stands for the ability to connect.
Earth, worry. But also the ability to plan and think ahead and provide means for growth
Metal, grief. But also the capacity to embody and resist
The list below elaborates on positive traits of emotions, before they become pathological73. The arrow
represents the positive transformation, and below that is given a practice and associations to facilitate
the transformation:
Fire: Joy (and madness) love
Politeness, humbleness, deference (sacrifice time for rituals and remembering your heavenly nature.
Earth: focus. Makes us real. Trustworthy, integrity (with ourselves, others and the universe)
Metal: Sadness reflection
ighteous ess a epta e/selfless ess , seei g the eaut i thi gs. ee the u
etal i the ea th,
es it happe ed, a d it is all ight
Water: Fear Awe
Wisdom, making yourself lower, you can learn from anyone. (water seeks the lowest point, and
minimum resistance)
Wood: Anger compassion
Wishing well and benevolence.
To finalize this paragraph we end with another positive note. Before it was said that emotions are there
to guide us in our behavior. When people get stuck in a certain emotion it is possible to address their
situation with an counteracting emotion, from the controlling cycle of five element theory we get74:
-
72
Anger counteracts pensiveness

Joy counteracts sadness
Pensiveness counteracts fear
Sadness counteracts anger
Fear counteracts joy
La gel
o i te p etatio s, i spi ed the efe e es a o e a d
(Saraswati, 2012)
74
73
Ma io ia s o
e t o this a out Wate .
37
Description of Emotions75,76
Although in TCM it is thought that emotions pertain to a specific organ, their effect is not limited to that
organ. To that end in describing the emotions emphases is made on the effect they have on different
organs. Furthermore I tried to relate al the emotions to the effect they have on the Heart. The effects of
expression and suppression are named, but not elaborated on. This will be discussed in the paragraph
Emotions and expression. I did t sti k to a of the t pi al u e s des i i g the e otio s. The a e a
selection of the most common ones described in literature.
Anger Liver, Lung, Spleen/intestines and Heart
All emotions are difficult to control, but from this quote77 Anger especially:
Of the se e e otio s, a ge is the ha dest to o t ol .
Li Yi-ru, Qing dynasty.
A quote provided by Maciocia also reveals this nature:
A ge auses loss of self- o t ol
Anger is, amongst others, related to resentment, repressed anger, irritation, rage and bitterness. It can
cover a deeper laying emotion like guilt and feelings of insecurity. The long term or intense presence of
these can injure the liver, leading to stagnation of liver Qi, stasis of Liver Blood, Liver Yang rising, Liver
fire, etc. Because anger raises Qi symptoms can include headaches, tinnitus, dizziness, red eyes, etc. The
involvement of Blood and the Hun make it also prone to forgetfulness78. If the Stomach/Spleen is
attacked also diarrhea can occur. As an emotion it is generally directed outwards, to others. Like the
earth element is wood element is also involved in making plans and pursuing them.
Anger is related to the Liver but also the Gall-Bladder. The latter is known as the rectifier, associated
with correctness. And it is also associated with courage and timidity.
Joy Heart (also related to madness, Kuang and Dian)
Joy in itself in not a pathological emotion, in moderate amounts it actually is very beneficial. What is
meant here is the overabundance in expecting or seeking joy, like partying all the time etc. It is this
craving for joy that is thought to be the root of emotional problems by Confucianism, Buddhism and
Taoism! In the Qi dynamic Joy slows down Qi and stirs up the ministerial fire, which disturbs the
Heart79,80 (imperial fire).81
On the other hand there is the condition of having a permanent lack of Joy in once life. This does t
refer to the undertaking of fun activities. What is implied is a lowering of standards for happiness and
Jo , u o ditio all . Not: I ill e happ if But just si pl the o tentment of being alive82.
75
(Maciocia, The practice of Chinese Medicine, 2008, pp. 282-298), for the general descriptions
(Larre & Rochat de la Valle, The Seven Emotions, 2005)
77
(Deadman, How to be Healthy, June 2005)
78
Good memory is made by communication of Spleen, Kidney and Heart
79
76
80
The difference of sovereign and ministerial fire also reflects pure and bodily (lust etc.) sensations.
81
This balance of fires and the balance of water and fire is very interesting, but outside the scope of the mind and
emotions for now.
82
38
Worry/Pensiveness (overthinking) Lung, Spleen and Heart

Thinking is about the correct perception of the senses and integrating information with memory by the
Heart. Normally this would be a balance between brain and heart, and the ability to plan further ahead.
The latter can also be pathological, always planning but not seeing the plans though.
Worry is a common emotion in our modern society, also called overthinking in TCM. It is said to
knots/stagnate Qi. Because of this it has an effect on the Lungs and Spleen. Leading to loss of
concentration and digestive s pto s plee a d shallo
eath a d hest symptoms (Lungs).
Knotting of Qi means there comes a new focus for the mind, making for an unbalanced mind and a
perpetuating nature of this emotion, like the element earth has the nature to attract.
Compared to worrying pensiveness has a more nostalgic note to it and is related to an excess of think
for example by studying, without worry.
Sadness and grief Lungs and Heart (and the Liver, Liver yin)
(also regret)
These emotions have a relation to regret, loss and breakups. They can be from the past, and the
tendency can be to mentally go back to that time. They can dissolve Qi causing deficiency and tiredness,
weak voice etc. If the deficiency last for a long time it can lead to stagnation. Sadness can also affect the
Liver yin. The impairment of this organ, and the Hun can lead to mental confusion, depression, no sense
of direction in life and o apa it to pla o e s life.
Sadness is related to the Heart and the Pericard, giving pressure on the Heart, its muscles and the
connections there. Because Heart is linked with Fire, there is a special relationship with Water. If there is
an imbalance between the two, water can flow from the Hearts orifice the eye, and there is crying.
Fear/Shock Kidney and Heart
(also fright and agitation)
Besides the relationship with the Kidneys, fear can also be related to the Liver and Galbladder and an
impairment of the Hun. The effect of fear in generally said to make Qi descend (effecting the Kidney),
giving symptoms like incontinence. But Maciocia adds that it blocks the upper burner Qi, Therefore
unblocking the Qi should be considered in treatment of fear (e.g. by the points He-5 and Lu-7). Fear can
also make Qi rise, in which case it will affect the Heart. In this case it can cause insomnia and
palpitations.
Shock also pertains to the Kidneys and is said to scatter Qi, making it chaotic. It creates an inability of the
to balance yin and yang in a person, facilitating a dissociation between spirit and essence, leading to for
example convulsions and epilepsy. However these convulsions and fright can also be related to a lack of
Blood (related to Liver and Galbladder above).
Love Heart
Like the other emotions we are concerned here not with normal affection but with the over indulgence
or inappropriate expression. Meaning persisting in loving someone who hurts you (mentally or
physically). It is also related to severe jealousy. It quickens Qi, affects the Heart and symptoms are:
insomnia, mental restlessness and palpitations.
39
Guilt Lung, Heart, Liver and Kidney

Guilt is very common in the west. It has deep foundation in our Christian culture. In TCM it is less known
and not so much described. Probably because the notion of guilt is not common to the three big
religions of the east. Guilt incorporates the feeling of responsibility of negative situations, a feeling of
regret for misdeeds (true or imagined), feeling of responsibility for negative of things happening to
others. The effect of the emotion is directed inwards, towards the self. In a sense it is similar to shame,
but guilt has more of a sense of inadequacy to it and much more darkness. The effects of guilt are
diverse, it can lead to Qi stagnation like all other emotions and it is closely related to Blood stasis. It can
also cause a sinking of Qi.
Shame Spleen, Kidney (and Heart)
Like guilt is also very common to the west. What is interesting is the notion brought up by Maciocia that
guilt is helpful for growth. It is argued that by knowing right from wrong and admitting your mistakes
contributes to wisdom. As such it is regarded as a positive emotion, because it aids to self-esteem. The
key again is moderation. If It is pathological shame is overwhelming and self-demeaning and it makes
you defensive and impotent.
Shame is more related to what people think compared to guilt, and it brings forth a feeling of wanting to
hide. Guilt you would still feel even if no one is watching you. Both are inwardly directed, leading to
stagnation and sinking of Qi. Often accompanied by Dampness, reflecting the feeling of di ti ess . With
a heavy sexual moral from Christianity and Protestantism in the west, it is interesting to see this
reflected by symptoms in the bodily areas of reproduction: vaginal discharge, excessive menstrual
bleeding, and also incontinence, prolapse of organs
40
Effects of emotions on the Qi Mechanism

Let s esu e the ge e al p o ess
hi h e otio s a e dis upti e83 with regard to Qi, Blood and other
pathological factors:
Rising
Emotion
Qi
Descending
Qi / Blood
stagnation
Knotting
Damp
Phlegm
Dissolving
Figure 9, Emotions are an expression of Qi, and have a disturbing effect in the Qi dynamic. Ultimately this will lead to Qi
stagnation. Because of the close relation to Blood, this can also lead to Blood stagnation. Both Qi and blood stagnation can
lead to Damp or Phlegm formation. And all of these factors in turn can lead to an emotional response. See also Figure 10.
All of the above emotions described in the previous chapter, and many more, can cause a disease. They
can interrupt the working of their corresponding organ, or stagnate Qi and blood flow.
We start from the point that an emotion can affect a related organ, but the reverse is also true. Looking
at an example of emptiness of Liver Blood, can cause Liver Yang rising with headaches, anger and
irritability. The other way around anger and headaches can have an effect on Liver Blood (facilitates
deficiency) and Qi (facilitates stagnation). See the below figure as a general illustration.
Emotion
Organ
disfunction
Qi/Blood
stagnation
Figure 10, the dysfunctional relationship between the (Yin) organs and emotions in case of a pathology.
Because emotions cause stagnation, organs more involved in the Qi mechanism are likely to suffer i.e.
the Liver and the Lungs, besides the corresponding organs from 5 element theory.
83
41
A more detailed description of the effects also on the Qi mechanism as it is commonly known in TCM is
shown in the table below:
84
Table 5, emotions and the effect on the Qi mechanism .
Emotion
Joy, elation (xi)
Anger (nu)
Thought,
thinking (si)
Sorrow (bei)
Melancholy,
worry (you)
Fear (kong)
Fright (jing)
Effect on Qi Transformation
Organ often affected
Causes Qi to slacken, moderates excessive emotions
Heart
Causes Qi to rise; moves to the head; blood follows Qi in Liver
counter flow
Causes Qi to k ot a d i d; Qi d a i does t o e
Heart, Spleen, Stomach
Dispels Qi; prevents free flow in the upper burner by
depressing the lung
Effects not described in Inner Classic; often combined with
sorrow
Causes Qi to descend; kidney fails to hold urine, feces, or even
essence
Causes disorder of Qi; affects the clarity of the heart; one
cannot think
Heart, Lung
Lung, Spleen
Kidney
Heart
The features described in the table above that make TCM so unique. Emotions (our interactions with
others) are related to our own appearance and health, giving way for objective interpretation and
diagnosis and treatment. Again this gives a feel for what is happening with your patient, but it also
provides a hint towards which organs systems might be involved.
Emotions and expression
In the previous part it was stated that key elements of life and health embody continuous change and
adaptation to- change. This also counts for mental health. But what is more important for mental health
is the relationship with our emotions. When we relate health with emotions there are two very
important aspects in case of a pathology, from the patients perspective:
1. Emotions are expressed to little
2. Emotions are expressed to much
It is very important to express your emotions. Not doing so can lead to depression and a desire to be
alone. Arguably this could be a reason why women live longer than men, because they cry and express
their emotions more compared to men.
Not expressing anger for a long period of time can be a cause for depression. Furthermore it is stressed
that anger is quite often used as a mask for other deeper lying emotions like guilt fear or shame. It is
important to be aware of this and to act accordingly in therapy.
84
42
The idea that in pathology of the mind is related to emotional expression is widespread. In Table 6 are
some examples described by Josef Mller85.
Table 6, emotional expression is key to health. Basically emotions can be over- or under expressed. Knowing either
characteristic can aid in diagnosis and therapy.
Organ
Liver86
Heart
emotion
Anger
Joy
Spleen
Worry
Lung
Kidney
Grief
Shock88
Under expressed
No expression
Lack of inspiration, mentally
closed when hurt
Too much consideration for
external issues. Empty center
Unresolved hurts
Life is o i g , ad e ali ju kies.
Over expressed
Loud, intrusive, much anger87
To ope : I
oke
a .
Haha
Too much sympathy for
yourself (narcissist)
Cutting away from grief
Paralyses.
The examples in the table above give some practical insight into whereas emotions are over- or under
expressed. Especially talking with your patients these references can readily come up. It is convenient to
have an easy reference as the table above, to help steer your thoughts in the right direction. Note that
not all emotions will give a distinguishing profile. But even this can be of help. E.g. in the case of anger,
so eo e does t ha e to sho sig s. But if du i g the i take ou fi d out that so e g eat i justi e has
been done to that person, and you do t see anger signs, you know that this is significant as well.
Fu the o e he e phasizes to th o a a ou
hite do to s oat, to get i o ta t ith ou
patients. It is easy to imagine why this is important when you look at the behavioral symptoms
described above. Their meaning is subjectively interpreted by the therapist. Being in a mindful and
compassionate state helps to come to the right diagnostic conclusion. Do you hear someone nagging
a d goi g o a d o a out othi g o do you hear someone suffering from grief and/or shock? The
e e is i the eholde ! Ideall ou ould t eed a ta le o so e efe e e like it, ut fo stude ts it
provides some help.
Objective subjectivity89
We can deduce from the previous chapter is that subjectivity is a challenge to overcome. Obviously this
is an inherent compromise that is fundamental to TCM, as it thrives on this subjective notion. You need
ou su je ti e skills to o e to a t ue pe eptio of ou patie t. But ou should t e misled by your
e otio s It was interesting to learn that a number of experienced practitioners seem to have found
o e a o a othe to deal ith the fla s of this su je ti it . Fo example Josef Mller uses a
technique based on muscle reflexes in combination with asking the patient what direction treatment
85
Internship at the Qing Bai academy, Amersfoort, 6 May 2012

Maciocia describes: for repression: stagnation of liver Qi and for expression: Liver yang rising with symptoms
above.
87
Statement not from Mller, it is my own interpretation
88
Ask fo t au a s. Shock cuts axis Ht-Kid
89
The description of the discussed practitioners and techniques is far too short to do them justice. Furthermore it
is my own interpretation of their work, it may not be accurate.
86
43
should go90. Dr. Wang has specialized himself in relating the internal disharmonies to manifestations on
the surface of the body. And he stresses the importance of making notes of every treatment you
perform, so you can afterwards objectify your choices at that time91,92. Yair Maimon uses a principle of
o e i ute diag oses hi h should allo ou asi TCM i sti t to take o e , a oidi g o pli ated
theories and artificial strategies93. Robin Saraswati has an approach where a mindful approach is central
i he p a ti e, the ap is guided
discussing the questions of life, to go to the root of the problem,
see Appendix 1.
In the framework of TCM for a single diagnosis there can be many possible treatment strategies. And
even the diagnostic principles can differ according to the particular tradition. To add to that the
variability from person to person, gives a lot of room for uncertainty. To have a method or principle that
helps you with structuring and objectifying can be greatly beneficial. See Figure 11 for a graphical
representation.
Classical
framework
Experience
Structured method
feedback
Chosen
therapeutical
strategy
Subjective
interpretation
Figure 11, To pin point your therapy in such a way that you get the maximum effect from your own interpretation within the
classical framework of TCM experience and objectivity are needed.
In the above figure we can see key factors in diagnosis and treatment. If we regards the classical
f a e o k of TCM as fi ed , the othe t o fa to s e o e dete i i g i the apeuti effi a . To
both of these experience is a key element. But besides that working in such a way so that you can collect
feedback (e.g. from your notes) and structuring your methods (as described above), can enhance
accuracy and effectiveness.
Having elaborated on the matters of diagnosis and emotions we now look at some examples of mental
distu a es a d thei t aditio al diag osis i the e t pa ag aph.
90
Internship at the Qing Bai academy, Amersfoort, 6 May 2012

(Ju-Yi & Robertson, 2008)
92
Course: introduction to channel theory and palpation, Dublin, June 2012
93
(Maimon, 2012)
91
44
Examples of diseases and TCM diagnosis

This chapter is just a short summary of generally seen patterns in mental en emotional diseases. Like
stated i the p efa e this pa t o t e ela o atel dis ussed e ause the e phasis is o the i d a d
the emotions themselves. To be accurate I do want to spend a few words on this subject, please see
them as a point for further reference.
Mental disturbances are many, to give an example here are a few which fit this description:
-
Excessive fear, Overthinking, Extreme sadness, over worrying, Depression (Yi Yu), Chronic
fatigue syndrome (CFS), Insomnia
Saraswati names a couple of additional conditions: Withdrawal (Dian), agitation (Zang/Fan Zao),
easily awakened (Yi Xing)94
Withdrawal is defined here as a numb effect, depression with no desire to communicate and a desire to
be alone.
CFS and depression can be thought of as general mental disorders. Meaning that most mental emotional
disease will likely have aspects of CFS or depression. The etiology given by Lee for CFS is also a broad
one:
1. Physical overwork
2. Mental exhaustion
3. Disharmony of life rhythm
It cannot be clearer, from this again we conclude that a moderate lifestyle is paramount. Related to
points three above, following the changes of the universal Qi95 is essential. This literally comes back in
several references. But also in the first two points above a large component attributed to lifestyle
factors. Exhaustion can also be thought of as the lack of rest or sleep and good quality of sleep is
beneficial for mental health. But often also our going-to-sleep-behaviour is prone for improvements.
Sleep is an interesting phenomenon related to the Mind. All or mental activities (seeing hearing thinking
etc.) consume Yang Qi, and when we are out of stock we lose the capacity to have a clear mind and to
have contact with the outside world. At night the Blood and Yin replenish and nourish the Yang Qi. Sleep
is related to the Hun and Shen, and thus is related to blood. If there is sufficient Blood Hun and Shen will
be healthy and sleep will be good96.
A number of TCM diagnosis is correlated to mental disturbances97, likely having a root in being unhappy
and being in an emotionally unbalanced state. The most important ones being98:
-
Qi Stagnation (Heart, Liver)
94

(Jie, 2012, pp. 1-5)
96
(Marsman, 2012, p. 2)
97
Please note that these are prominent examples, not a complete list
98
95
45
Blood Stasis (Heart, Liver)

Heat or Fire (possible due to long term Qi stagnation)
Damp or Phlegm (associated with Spleen function) clouded mind
Heat toxicity (from long term EPF, traumatic experience, bad life style: diet and time)
Kidney deficiency (yin vacuity fire)
Spleen deficiency (yin vacuity fire)
The patterns can be described more specifically, Qi stagnation often has to do with the Liver, and Damp
and Phlegm can be related to Spleen function.
Each of these factors can contribute to the formation of the next: Qi stagnation can lead to Blood stasis,
both of them can cause Heat or Fire, and the combination of stagnation and Heat can lead to Dampness
of Phlegm. Al of them hinder the function of the Qi mechanism and Damp and Phlegm add to that a
barrier, possibly isolating the Mind and or Heart.
46
Summary for mind and emotions

It can be said that the concept of health embodies the capability to react, change an respond according
to the circumstances at hand. These can be social or psychological events as well as the changing
environment as it normally occurs in nature.
Emotions disrupt the Qi mechanism leading to stagnation. Although they are correlated to specific
organs their disruptive effect is not limited to a single organ. Specific symptoms can be deduced from
organ relations, Qi movement impairment by the emotions (anger makes Qi rise, giving headaches and
tinnitus etc.) and the behavioral aspect of the emotion. Qi stagnation can lead to stagnation and
defi ie
of Blood, aki g that the he a t eside there and mental emotional problems can arise.
In the end all emotions will affect the Heart, when the Heart is disturbed it loses its ability to orchestrate
all the different aspects of the mind (Wu Shen, five spirits) coherently and this lead to mental emotional
disturbance as well.
Emotions have a bad PR so to say, but they do have a function, both from a western perspective as in
TCM. Looking at the five virtues (aspects of the five shen) can help guide a negative emotion into a
positive trait. And these virtues can provide a guides of where we need to go to in therapy and life as
well.
It is crucial to be compassionate and mindful for the patient you are working with, interpreting their
emotions can also interfere with yours. Are you merely observing or also projecting and reflecting? To
this end it can be helpful to incorporate techniques and manners which will allow you to objective your
own (subjective) practice. That is of course besides knowing about the different aspects and emotions as
they are described in TCM, knowing these will also help finding out what is going in with your patient on
a Shen level.
In this chapter, mind refers both to memory (in the West) and an integration of the five psyches in TCM.
It is natural to express emotions and this should be done so in a balanced fashion, not too little, not too
much. When however you are working with your patient on an emotional level you should always take
into consideration the fact that they cannot directly understand and/or control their emotions. An
intellectual understanding of how the mind works, and techniques (meditation) to redirect emotional
outes i thei ai s a help the pe so a d thei t eat e t. Thus it is i po ta t to k o e otio s
diagnostically (and correlate them accordingly to therapy).
In treatment it is important that you adopt to a method that allows you to objectify the subjective
interpretations you make. This can be by means of a journal, first impression (not overthinking), by an
understanding of emotional expression patterns and many other possible techniques.
47
Mindfulness
Mindfulness is a modern term that relates to what Sun Simiao was thought to introduce first in TCM,
namely Yang Shen, or nurturing life. He did so by integrating cosmology with the ethical ideas of
Confucianism and Buddhism, leading to a new means to spiritual, personal and social cultivation. He
emphasized greatly the importance for the physician to have a sound moral99:
I o es dail p a ti e, o e ust ha e a attitude of
self-possession and concentration; have a dignified
appearance; treat all patients equally with no regard
to wealth, gender, status, nature of ailment or
potential rewards ... while abstaining from luxuries
and from criticizing o es fello ph si ia s.
Mindfulness is the modern term that basically denotes a moderate and compassionate lifestyle. It
involves a healthy moderate diet, exercising, resting well, self-massage, sunshine (going out) and a quiet
mind100. But also includes respecting the products you use and the food that you eat and having a
positive attitude towards life (just because..)The quotes below referred to by Peter Deadman101
illustrate to all this very well:
The easo h the i tuous li e lo g is that the a e ot
greedy for out a d gai s a d a e a le to keep i a d pea e .
Dong Zhongshu 179 BCE-104BCE
The less o e eats, the oade his i d a d the lo ge his life
span; the more one eats the narrower his mind and the shorter
his life spa . Zhang Hua, Jin dynasty 265-420
Be cheerful whether rich or poor, He who does not laugh can
only be .a fool . Bai Juyi
A t easu ed f ie dship a epla e eg et a d hat ed a d heal
the old wounds of the mind. Such a friendship can provide
sincere help, consolation and encouragement. These can be
magic weapons for elimination of grief and anxiety. When your
life is free from anxiety and grief, you will find food tasty, sleep
estful a d e eatio e jo a le . Xu Xiangcai
We can take from these quotes, the basic premise of mindfulness, moderating, avoiding or minimizing
craving and passions (in the negative sense), to be joyful and to share your life and happiness with
others. This is the reason why people of ancient times aged well:
99
(Wilms, 2012, p. 6)
101
(Deadman, How to be Healthy, June 2005)
100
48
Reached one hundred years of age without decline in their activities102

Moderation is a key aspect to prevention of mental emotional disturbance according to Maciocia. He
summarizes to avoid: excessive thinking and craving, and distracting thoughts.
Mindfulness in therapy means being there for you patient, with full attention and compassion. But also
ea s hea i g g eat espe t fo a health a d ala ed state, a d ei g su e that ou do t distu this
if and when encountered.
There are many practices which will help to cultivate a mindful state of mind. Rituals are important
therein, as this helps you remember and focus on your virtues or heavenly nature. So this is the
foundation of a mindful lifestyle to create and harbor activities that will allow you to remember your
heavenly nature. This is the same for everyone, including therapist and patients. Examples of practices
are given in the paragraph, Aspects for therapy.
Mind and emotions of the acupuncturist
In the Suwen several paragraphs are dedicated to the skill of the healer. For instance in this passage
where it asked why physicians who know TCM and know the patient still can prevent illness from
manifesting103:
A good heale a
ot depe d o skill alo e. He ust also ha e the o e t attitude si e it

compassio , a d se se of espo si ilit .
With this we are again reminded that it is both what and how are important.
This sincerity and compassion ultimately is put to use to become a top level physician , one who sees
hat the a e age p a titio e a ot see. Of ou se if ou a ot pe ei e ou ask and feel for the
discomfort, you go with what you have got. To reach this level you do not just go with what is told by
your patient, rather it is Shen that guides you. Again a beautiful and insightful quote from Fruehauf104:
You e es see the i isi le, ou Hea t is ope , a d ou i tuiti e se si g is f o t a d center. All of a
sudden then, the subtle truth will reveal itself to you, without being able to put your experience into
words, seeing while everybody else does not; as if the night turns bright for you alone while everybody
else remains in the dark, like the invisible hand of the wind moving the clouds. That is why it is called
Shen, mysterious.
E e
o e i sightful is the o lusio d a
f o this, that i g aspi g Qi,
ot fo usi g o the
Shen and the subtle aspects, you actually contribute to the manifestation of the disease and thus the
decline of the body.
102

(Ni, 1995, p. 54)
104
103
49
As a healer, or patient, we all benefit from cultivating our minds. It is important to try and make it a daily
ritual, that suits you personally. Besides that other activities you can adopt as often as required (or
possible, like a retreat). Examples are:
Writing, journaling, fasting, retreat, chanting, contemplation, meditation, sauna, exercise, yoga, tai chi,
Qi Gong, going to a religious place, etc. But in can be also as simple as a candle and a table. Prayers or
a t a s i d p oje tio s a e e helpful as ell. The i po ta e is that ou put ou i d to it, do it
daily (so it becomes a habit for when you need it).
Qi Gong105
To highlight one of these Qi Gong is found to stop mental processes while consciousness and awareness
are maintained. Because the brain is temporarily relieved from external stimuli the brain function
achieves a high degree of coherence. Furthermore it is found that general energy consumption is
lowered, the bodily rhythm is improved, and the Qi flow is in the correct direction and in the right
meridians.
It is to be expected that with these properties, positive effect are to be expected for (mental) health.
Indeed Qi Gong is found to be effective in a wide range of diseases. Related the mind it was found to
regulate hormones and emotions, improves mental agility, short term memory and increase the
attention span. Furthermore there was an increases sense of inspiration and creativity.
In TCM there is a group practitioners who use medical Qi Gong to treat people, this is also done in
combination with acupuncture.
Aspects for therapy
Describing this perfect state of mind in the previous paragraph, the obvious question is how. What can I
do to become better? It start with remembering your heavenly nature, and adopting activities that
encourage that (walking, meditation, retreats etc.) like described before.
Then we can incorporate rituals106,107 to adopt in treatment specifically. To follow the tenets of ancient
times and to experience their magic in the present. To keep the inner eye on the subtle and mysterious /
the unlimited.108,109:
1.
2.
3.
4.
Have unity of mind and spirit do t be scattered)

Understand and practice the Tao of self-preservation and cultivation
Be familiar with the true properties and actions of each herb
Be proficient in the art of acupuncture
105
(Guo, 1994, p. 2)
Rituals or methods are also discussed in Objective subjectivity
107
Rituals are also important in ancient China, they are deeply embedded in the culture, to help people adapt
though with appropriate regard to emotions and social circumstances (Fruehauf, All Disease Comes from the
Heart, June 2009).
108
(Ni, 1995, p. 101), Su Wen Chapter 25
109
From a standpoint of an acupuncturist the list could also be reversed. But it is safe to assume that the Spirit is
first and foremost in this classic.
106
50
5. Know the art of diagnosis

Fruehauf110 interprets it similarly, but slightly different:
1.
2.
3.
4.
5.
Treat the spirit

Know how to nourish the physical body
Know the true transmission of herbal medicine
Work with large and small needles
Know how to diagnose the state of qi and blood in the fu and zang organs
They are very similar however I appreciate the interpretation given for point number two, it makes it
somewhat easier to understand.
A lot of the quotes used so far have to do with mindfulness and how important it is. o I o t epeat
the effort here. We can use this part in concluding that it is very important to focus your mind,
illustrated here:
the li i ia should ulti ate the a s of hea e a d ea th, u de sta d the d a i s of the hu a
spirit, and ponder the depts. Of nature. One will then grasp the Dao
Again these are very high end ambitions to go for. The practicality in it is to have an open Heart and to
be objectively critical of yourself. So this means keeping a personal journal to observe them, but also to
record your findings with patients. In treatment then it is also important to allow all your emotions (also
negative ones) and to let a situation be uncomfortable. This way you can record it and learn about it
late . If ou do t allo it, it ill e e su fa e e ou a e lo ked.
This mindful state allows you to ask the proper questions in treatment and prevents you from
sidestepping from the moment/experience at hand. Adapting to a structure to get your mind in the right
state is very helpful for this. To that end I already described possibilities in the chapter Objective
subjectivity.
In the end we can reduce al the complexities to say that, you need to simply observe what is out of
balance, and bring it back in to balance111. As difficult and complicated TCM can be, the basics remain
simple.
Talking and other aspects of therapy
As we know there is a psycho- emotional aspect about knowing the mind and recognizing it with your
patients. It that way you can use this to facilitate an intellectual understanding that helps and aids
treatment, especially since emotions are so connected to memory and per definition behavior. They can
become a sort of conditioned (bad) ritual.
There also is the notion of controlling your emotions by also rational reasoning. This entails a cultivation
of morality and will, the conscious control over ones mood and overcoming emotional impulses with
110
111
(Fruehauf, All Disease Comes from the Heart, June 2009), ref: Chapter 25 of the Suwen
(Maimon, 2012)
51
reasoning112,113. The (first) authors continue with practical notes; to consider that is important when you
get angry, your emotion or your health? Than from that statement they aim to overrule the emotions
and thoughts in the patient by giving powerful examples of healing done before and other reasoning.
Furthermore the awareness of the harmful effect of egoism and desires is stressed. And reference is
made to the six harmful influences114, which should be diminished:
-
Fame and profit

The desire for sex
Wealth
Rich food
Unrealistic fantasies
mind
Jealousy
desire should be suppressed

to which one should not abandon oneself
for which one should not be greedy
be moderate with
get rid of, they distract thought from reality and are harmful to the
should also be eliminated
In a way they resemble the negative aspects from the emotions discussed earlier, but most of these
points have more of a social context to them.
It is stressed that a broadminded and positive attitude toward life, and having lofty and respectably
ambitions, a sound moral, are a the fou datio to atta k these ha ful i flue es. The fo
the
basis for further progression. Also relating to the five Shen and corresponding five virtues.
Now when we want to decipher which emotions are relevant to our patients when talking to them,
these are some questions from Saraswati to help115:
Wood: How feel do you feel right now?
Fire: How much are you willing to love yourself, rather than have the world love you?
Earth: How well are you able to maintain boundaries in your life? (Spleen no energy, but still helping
others)
Metal: How much are you willing to let go?
Water: Can you reach the part of your being that is unshakable?
With this the hat is defi ed elati el lea l , o
hat a out the ho ? It is important to reduce
the temperament and ease the mind, and seeking activities that help to this end. For example carefree,
112
113

114
Fruehauf also describes six emotions should be warded off like one does with dogs, dears, fish,
monkeys, birds and snakes114. I assu e e should t take this to lite all a d that the e a e thought to
be behavioral traits associated with these animals. Furthermore he concludes to say that where there is
a a se e of desi e a d e otio s, e the )a g a e pu ified, the the e is a ple oo fo the light of
pi it .
115
(Saraswati, 2012)
52
lively and light exercise is thought to activate Qi and Blood, spirits are raised, intelligence increases and
the muscles and tendons are exercised. These activities are thought to prevent illness and increase
longevity. This means for practitioner as well as patient, again.
When faced with complex situations and emotions, one angle of treatment is to counteract and control
them actively. This can be done with reasoning, providing an outlet for the emotion (as a friend, family
member or TCM therapist you can facilitate this)116, diverting attention (playing music, going for a walk
etc.). Writing down your thought patterns can be insightful and help to create distance from that
negative emotion or thought pattern. Finally we can try counteracting with opposing emotions. For the
latter see the table below:
Table 7, the psychotherapy method of Zhu Dan Xi is based on the below interactions of emotions.
Emotion
Anger
Ecstasy
Anxiety (and Sorrow)
Sorrow
Fright
Diversion
Diverted by Sorrow
Restricted by Horror
Restricted by Joy
Restricted by Contemplation
Curbed by Anxiety
Mitigation
Fear
Alleviated by Anger
Alleviated by Anger
Alleviated by Anxiety
Relieved by Horror
It is interesting to see that anger even though it is toxic as en emotion it can be used in tempering both
Anxiety and Ecstasy. To me this is a new approach and it seems worthwhile. I can imagine someone
partying too much or lacking joy in life can benefit from horror in the sense that connecting them with
an angst will confront them. In both cases, I think, it could confront them with what they will miss out
on, if they keep up their current behavior. Anger next can provide the necessary impulse to get up and
do something about it. At this point it would be too much too elaborate on all of the individual aspects.
The basic idea is there, and right o it is t the goal to o e all the possi le i pli atio s.
All the examples above are there to help relate your patient. To help them reach where there are
emotional problems in Appendix 1 there is a list with important life questions. These can provoke
emotional responses and provide insight in the condition of the mind.
Mindset for therapy
All these various aspects of mind and emotions are, like TCM, quite complex and you can get easily
confused or derailed by all the different aspects to consider. That is why focus and the right mind set are
so important. A reference on how to do that comes from Sun Si Mao who stated that for treatment the
doctor:
1.
2.
3.
4.
Calm your mind (breathe)

Take your Zhi (wisdom from the Kidneys, will power and determination)
Let go of ou ego do t fo us o esults, o ha e thought like I the est do to et .
Hold nothing back (connecting with your patie t
i g ou self to the ta le
116
The latter can be done spontaneously or controlled. The latter is supported by friends and family members and
are supported by e.g. writing and poetry.
53
5. Initiate your kindness

Saraswati has this related manner of preparing yourself for practice:
1.
2.
3.
4.
Set intention (think and feel in the body

Relax (belly breathing 3x (3 seconds inhaling 9 seconds exhaling)
Feel safe, mentally bring in teachers, loved ones, pets, divine beings
Cultivate feelings of wellbeing (loving kindness or anything positive), for yourself and for all
sentient beings
5. Soak it up, like a sponge (3 breaths closing)
To add to letting go of the ego, it is not important, or even required to cure immediately and expect
such results. Healing, like life, is a process, you aim it to be better in the future117.
Then with full focus and attention on the tip of the needle you are ready to start your acupuncture
treatment.
Summary for mindfulness
Mindfulness describes a variety of concepts related to the concept of Yang Sheng, which in turn is about
finding or discovering your true virtues (or positive traits / heavenly nature). Being involved with
activities that harbor this is beneficial for health and longevity, for both patient and therapist. From the
perspective of a therapist is helps accommodate compassion and focus on your patient, and it helps
deflecting the restricting effects of the ego. Sunsimio who was at the foundation of the concept of Yang
Sheng stressed the importance to self-cultivation and a sound morale in practice, this includes practicing
TCM with the upmost compassion and selflessness. His notion at that time was to redefine the definition
of life, leading to new insight into spiritual, personal and social cultivation.
So cultivation of your mind is key in practice and therapy, and adopting a ritual to perform these is very
beneficial.
I will close with this beautiful quote which applies very well to our modern times, if we change
alchemical preparations for medicine (or instant fixes)118:
The Pe fe ted Pe so said: E e if ou o sta tl
ingest alchemical preparations but do not know the art
of nurturing life, it will still be difficult to extend your
lifespan. The way of nurturing life is to constantly strive
for minor exertion but never become greatly fatigued and
force what you cannot endure. Moreover, running water
does not grow stale, the pivot of the door does not get
bug-infested. The reason for this is that they move.
117
118

(Wilms, 2012)
54
55
Discussion
I have tried the give answers to this central question:
A d f o that spe ifi o lusio s a e ade. What is t a s e ed is why mostly behavioral related
afflictions keep throwing us of balance. Reflecting on this it must have to do with the artificial context
we are living in. The following quote from the Suwen119 provides insight, it starts with describing the
various aspects of modern life that are off balance. And then this is stated :
they make every effort to please their hearts, [ ut] the oppose the [t ue] happi ess of life
By just looking at this I would deduce that pleasing their hearts means indulging in the five emotions and
their elated aspe ts. I ould t e a le to hold this up to the ight efe e e. Lu kil i the
commentary by Unschuld a useful reference is made to nourishing life (Yang Sheng):
To fi d pleasu e i
ealizi g o es hea ts desi es is to ou te a t the happiness that can be obtained by

ou ishi g o es life
From that statement I conclude that there should be more awareness of the notion of Yang Sheng. It is a
diffe e t f a e to hold ou life s sta da ds to. O o e oughl stated, it puts a social and moral frame
to our own desires and ambitions. Without going into its particular aspects, I think it would be a valuable
reference to our modern western life style.
Directly or indirectly a lot of the aspects of health and disease are related to a balanced and harmonious
life, free from desire, resting and eating appropriately. Ultimately health is directed to the discovery
(and road towards) your Virtues .Rituals can provide help and structure to that end, for both
practitioners and patients.
I think this is the most profound conclusion to be made. Besides that I argue that there is an artificial
environment that we need to consider when we look at harmonious living these days compared to the
original time frame where TCM originated from. To that end we need to consider the limitations of a
true harmonious lifestyle, whilst still participating in society.
With this broad subject of the mind there are matters which could not be discussed in thesis and could
be at the basis of feature research. For example the concept of Yang Sheng and activities that go with it
like Qi Gong. They have been described in the context of an healthy mind, but were not the main subject
as such. Also the five Shen could easily be the sole subject of a thesis. I came across very interesting
references of the Hun in relation to mental health, or the role of ministerial versus imperial fire. I judged
it to be too technical for this thesis, and relating to the preface, it also out of scope because I wanted to
focus on the practicalities of working and discussing the mind and emotion. A good point for further
research.
119
(Unchuld, 2011, p. 33)
56
Bibliography
Al-Khafaji, P. D. (1995). The Treatment of Psycho-Emotional Disturbance. JCM, 32.
Coleman, D. (2007). Destrictive Emotions. The life and mind institute.
Deadman, P. (June 2005). How to be Healthy. Journal of Chinese Medicine 78, 41-48.
Deadman, P. (May 1981). The Causes of Disease (part one). Journal of Chinese Medicine 7, 1-9.
Deadman, P. (September 1981). The Causes of Disease (part 2). Journal of Chinese Medicine 8, 1-7.
Deadman, P., & Al-Kafaji, M. (1995). The Treatment of Psycho-Emotional Disturbance by Acupuncture.
Journal of Chinese Medicine 47, 30-34.
Ellis, A., Wiseman, N., & Boss, K. (1989). Grasping the Wind. Paradigm Publications.
Fruehauf, H. (June 2009). All Disease Comes from the Heart. Journal of Chinese Medicine 90, 26-35.
Fruehauf, H. (May 1995). Mental Disorders. Journal of Chinese Medicine 40, 21-34.
Guo, B. (1994). Introducing Qi Gong. Journal of Chinese Medicine.
Henricks, R. G. (1989). Lao-Tzu Te-Tao Ching. Ballantine Books.
Jie, D. L. (2012). Yi Yu and fatigue syndromes in TCM. Amsterdam: Qing Bai.
Ju-Yi, W., & Robertson, J. D. (2008). Applied Channel Theory in Chinese Medicine. Eastland Press.
Larre, C., & Rochat de la Valle, E. (1998). Heart Master, Tripple Heater. Monkey Press.
Larre, C., & Rochat de la Valle, E. (2004). The Heart, Ling Shu chapter 8. Monkey Press.
Larre, C., & Rochat de la Valle, E. (2005). The Seven Emotions. Monkey Press.
Linden, M. v. (2006). Hersenen en Gedrag. Amsterdam: Boom.
Liren, Y., & Xioming, L. (1993). Health Preservation by Mental Means. Journal of Chinese Medicine 43,
35-36.
Maciocia, G. (2005). The Foundations of Chinese Medicine. Elsevier.
Maciocia, G. (2008). The practice of Chinese Medicine. Elsevier.
Maimon, Y. (2012). One Minute Diagnosis. Amersfoort .
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Ni, M. (1995). The Neijing Suwen . Shambhala.
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Rossi, E. (2007). Shen: Psycho-Emotional Aspects of Chinese Medicine.

Saraswati, R. (2012). Chinese Medicine: Psyche, spirit and the energetics of emotion. Amersfoort.
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58
59
Appendix 1
Questio to efe to i ou o e satio s, to help the ea h thei t ue atu e a d eet up to life s
ambitions120. Please note that it can be that some matters can only be discussed when it is the right time
for the patient and can also depends on the relationship between patient and therapist.
1) How is the current relationship to the significant people in your life?
a. How has it been in the past?
b. How would you like it to change?
2) What are the significant events of your childhood?
a. Of your adulthood
b. What is incomplete in your life?
c. What has been completed?
3) What is the history of- and relation to your job?
a. Does it give you support?
b. Is it a burden?
c. Is it what you want to be doing?
4) What changes has your health problems brought in your life?
a. Job/work
b. Family/friend
c. Self-esteem/self-worth
d. Have there been any benefits? How does your health situation benefit you?
5) Has the health problem confirmed or changed your ideas about who you are?
a. Has the problem a special meaning or lesson for you?
6) How do you care for yourself? And how do you care for others? And has your health condition
changed that?
a. How do you abuse or neglect yourself?
b. What doe you value most in yourself?
c. And has it changed since the illness?
7) What do you consider the major disappointments in your life?
a. What are your major successes?
b. What are your major learning experiences?
8) What are the source of pleasure in your life? (can be guilty pleasures Shame)
a. Where do you recognize sadness in yourself?
b. How do you deal with the pain?
9) What are your most recurrent feelings (e.g. lonely, anxiety, inertia), thoughts, expectations,
fantasies, dreams, plans, fears, memories, obsessions?
10) For the practitioner: What response does the patient evoke from you? (you are a mirror (versus
projection) try and create resonance, to see and to be seen)
120
(Saraswati, 2012), reference to Ted Kapcuks 10 question.
60
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The mind in the use of acupuncture

The mind in the use of acupuncture

The mind in the use of acupuncture ............................................................................................................. 1

is that ou thi k ou e got it, ut eall , ou do t. And you

diseases like: diabetes, blood vessel and heart

o d does t do justi e to the

iss all that heavenly glo

hat is ot dis ussed o ela o ated o . Fi st of all this is t

ot alled the o ki gs of the

i d or something like that. This means

people that do t ha e this a kg ou d. O e of the aspects why I

Mea i g the a tual e e g it osts i te

s of p odu i g pathoge s, as ell as the odies st uggle agai st

atu e, li ati fa to s, e e ts , pla eta

Pa ado i all the soul he

a ifestatio of the hea e l Ya g e e g

Maciocia11 describes it as follows:

Consciousness, pure connection to the macrocosm. (Saraswati, 2012)

o t ol. (Saraswati, 2012)

efe ed to as: the spi itual a is

. It is also interesting to see that in humans correlate to Qi as well as

(Maciocia, The Foundations of Chinese Medicine, 2005, p. 69)

istake the a se e of e ide e fo the e ide e of a se e

The definition for health coming from the WHO is as follows:

Quiet peacefulness, absolute emptiness

(Larre & Rochat de la Valle, The Seven Emotions, 2005, p. p. 51)

o e se e e a d o ple disease, that is atta hed to a pe so s ighteous Qi i side the od

Fruehauf ela o ates: o the

ea s affli tio of the hea t a d su

a situation where so e od has e o e ph si all ill due to

e tal, e otio al, o spi itual auses

Internal causes of disease (emotions)

(Fruehauf, All Disease Comes from the Heart, June 2009)

And their blinding or overwhelming character:

(Larre & Rochat de la Valle, The Seven Emotions, 2005, p. 30)

Familial history (Jing, genetic)

(Saraswati, 2012, p. 23)

(Maciocia, The Foundations of Chinese Medicine, 2005, p. 285)

Summary for health and disease

Mind and emotions

(Larre & Rochat de la Valle, The Seven Emotions, 2005, p. 29)

Transforms into blood and vice versa

Commander of blood/ blood is the

Figure 6, Jing-Qi and Shen are all closely related to Blood.

(Maciocia, The Foundations of Chinese Medicine, 2005, p. 110)

Aspects of the five Shen

Indulgence, attachment etc.

(Rossi, 2007, p. 14)

(Ju-Yi & Robertson, 2008, p. 76)

Virtues of the 5 shen

Intent, reflection (yi)

Organized logical thought

Spark of intelligence, recognition

Essence (jing) / Will (zhi)

Ability to finalize intended action

(Ju-Yi & Robertson, 2008, p. 77)

Anger counteracts pensiveness

e t o this a out Wate .

Worry/Pensiveness (overthinking) Lung, Spleen and Heart

Guilt Lung, Heart, Liver and Kidney

Effects of emotions on the Qi Mechanism

(Maciocia, The Foundations of Chinese Medicine, 2005, p. 301)

Table 5, emotions and the effect on the Qi mechanism .