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Home > Newsletters > December 2007 > Chinese Medicine and the Mind - Page 2

Chinese Medicine and the Mind - Page 2

By Efrem Korngold, LAc, OMD and Harriet Beinfield, LAc

Thus, it can be seen that, whereas some predominate in the hierarchy of functions, all Five Organ Networks participate in the development and preservation of awareness, thinking, memory, perception, balance, orientation, discrimination, temperament, and judgment. Each contributes particular aptitudes and tonalities to the mix that, from a Western perspective, we understand as the neuropsychological basis of consciousness, integration, coordination, and adaptation. Disorganization of any or some of these Networks or functional terrains has a profound impact on the integrity of both cognitive faculties and neurological competencies.

HOW CHINESE MEDICINE VIEWS DEPRESSION

Webster’s dictionary defines depression as, “a state. . . or disorder marked by sadness, inactivity, difficulty in thinking and concentration, increase or decrease in appetite and time sleeping, feelings of dejection and hopelessness, and sometimes suicidal tendencies; a lowering of Vitality or functional activity.” The last phrase, “a lowering of Vitality or functional activity,” goes to the center of Chinese medicine’s understanding of the root causes of depression: that emotional and behavioral symptoms are manifestations of an underlying constraint, collapse, or dissolution of Qi that weakens and destabilizes the core identity or self (Shen-Jing).

All diagnoses in Chinese medicine conform to the Yin Yang— Five Phase paradigm regardless of whether the illness at hand primarily expresses itself somatically or psychologically. In the West, depression tends to be regarded as a psychological illness arising from a dysfunction or dysregulation of neurotransmitters in the brain, although this hypothesis is speculative, and the origin and nature of this pathology is poorly understood. In the view of Chinese medicine, because the unity of Shen-Jing is indissoluble throughout life, there is no illness— or for that matter,
health—that does not arise out of a synchrony of interpenetrating psychic and somatic processes. Even a purely mechanical injury such as a bone fracture is an insult to the organism as a whole that, potentially, may have a serious impact on the psyche, leaving the person feeling fearful and vulnerable long after the tissue damage has healed. Conversely, emotional trauma following the witnessing of a violent act can have a
profoundly destabilizing effect, resulting in chronic somatic complaints such as an irritable bowel or recurring headaches. Adaptation—the process of responding to stress, integrating experience, and organizing a coherent response that sustains individual and social life—is a product of the coordinated interaction of the Five Organ Networks and five body constituents (Mind, Qi, Moisture, Blood, Essence), which govern the body in accord with the laws of Yin and Yang and the formative power of Qi.

Nonhedonic states characterized by varying degrees of dysthymia or dissonance of “mind and will.” In fact, manic depression used to be called cyclothymia, unpredictable cycles of mood and behavior alternating between feelings of despondency, sluggish thinking, apathy and elation, grandiose thoughts, and gregariousness. In Chinese medical terms, the robust bond between the Mind (Shen) associated with the Heart Network and the Will (Zhi) associated with the Kidney Network has become too loose or, at worst, undone. This deep level of disorganization weakens a person’s ability to maintain a realistic view of the world, compounding a sense of dissatisfaction, disappointment, and disconnection with a personal and social life.

Because the core of individual life is the relationship between the Shen-Heart and Jing-Kidney, any serious or prolonged trauma, shock, illness, or deficiency can potentially damage this vital link, depending on the vulnerability of the individual. Vulnerability is not something that can be easily quantified, but it can be assessed by the classical Chinese methods of pulse, tongue, and physiognomic diagnosis. Any disharmony, ie, disruption of the interaction, between the Heart and Kidney Networks predisposes a person to destabilization from shock or injury. For example, stressful events as diverse as the loss of a loved one, injuries sustained in an auto accident, impairment following an illness, or exhaustion because of excessive physical or mental strain may not only deplete the body of Qi but may disrupt the coordinated interaction of the Organ Networks. What makes the organism adaptive, namely sensitivity
and responsiveness to the internal and external environment, also exposes it to the possibility of being overwhelmed. Many people come into the world with preexisting weaknesses, both inherited and congenital, that make it difficult for them to recover from insults, whether physiological or psychological. Their tolerance for stress is relatively reduced in comparison with those who have a hardier structure and a more resilient character.

A well-known instance of physiologically induced depression is that experienced by women following childbirth. The extreme effort required by body and mind during the process of labor can exhaust the Qi of the Kidney, especially its adaptive reserves (Essence or Jing)—what medical biologist Hans Selye termed adaptation energy. The immediate elation of accomplishment and fulfillment, the pleasure and joy facilitated by the Heart, cannot be sustained and is soon followed by feelings of fatigue, apathy, insecurity, melancholy, and emptiness because of the weakness of the Kidney. The desire for happiness and delight in motherhood remains, but the power to engage the self is diminished. This is one reason why, in Chinese society, the ideal support for a new mother is focused on insuring optimum rest, nutrition, and protection from physical and emotional strain so that her body is able to adequately replenish its
adaptive reserves of Qi, Blood, and Essence. If restoration of the Kidney Qi does not occur in a timely manner, depression may become chronic and potentially devolve into a much more serious and complex condition with additional features such as Anxiety, panic, paranoia, uncontrolled weeping, dissociation, and paralysis of motivation or will.

Depression because of emotional trauma or shock is most often the result of an injury to the Qi of the Heart. Abandonment, betrayal, assault, humiliation, and divorce all offend the organism’s sense of empathy, trust, safety, optimism, integrity, and, above all, connectedness. It is the job of the Heart Network to shelter the Mind (Shen) and enable us to experience the enjoyment of belonging, being part of an entity greater than ourselves. The sudden realization that we are alone, and at the mercy of people or events indifferent to our personal needs, desires, and destiny, can lead us
into a pervasive feeling of loneliness, sadness, pessimism, meaninglessness, and inertia. Without pleasure, security, conviviality, belief in the friendliness of the world, and meaning, life loses its purpose,
and anguish reigns. The physical energies for living may still be present, but the assurance that life promises fulfillment has become doubtful or even lost. This is depression due to a lack of spirit rather than a lack of will. Although the Kidney-Heart relationship is at the core of organismic
integrity, the Liver, Spleen, and Lung Networks play both minor and major roles in the etiology of depressive disorders. Next to Heart- and/or Kidney-related depression, disturbances of the Liver Network are a frequent cause of gloomy moods and negative attitudes toward life. The Liver likes to move freely and is the source of courage—of boldness and determination. Its Qi is easily perturbed by rage, frustration, alarm, or hurt feelings and blocked by excessive emotional restraint, particularly the suppression of anger and indignation. The Liver is weakened, its Qi dissipated, by persistent doubt, indecision, and apprehension. Disturbances of the Liver often manifest as irritability, volatility, and negative expectations. In particular, repeated experiences of frustration and failure undermine self-confidence. This leads to a kind of depression characterized by timidity, self-condemnation, scorn and blame of others,
irascibility, and a sense of futility.Onthe other hand, Liver-type depression can be relieved temporarily, or even permanently, by successfully responding to an emergency or opportunity involving personal risk and the urge to rescue others. Becoming aroused by another’s need dissipates the stagnant Qi, frees the body to act, restoring optimism and self-confidence. It is also the case that exhausting oneself in the pursuit of one’s perceived goal or mission depletes the Qi of the body as a whole, but ultimately of the Kidney.

Because, in this situation, the Liver no longer has resources to draw on (the Kidney Jing/Essence), the person will begin to feel that the creative well has run dry, as if he/she is going through the motions of life out of habit, without enthusiasm or vigor. This is the typical burn out crisis of the successful workaholic, who, believing in his/her own unlimited power, finally runs out of steam and retreats into a bleak, colorless sanctuary of emotional and physical boredom and torpidity.

Other circumstances induce the Spleen and Lung Networks to display their own kind of misery. The Spleen and Lung are closely aligned as the second and third sources of Qi, following the Kidney as the first or original source. The Lung receives air through respiration and extracts Qi from it just as the Spleen receives food and extracts Qi from it. When the Spleen transforms solid and liquid into Nutritive Qi, this forms the constructive portion of the Blood and is combined with the Air Qi to form the Pure Qi of the body that circulates in vessels and channels. Because the Lung and Spleen are receptive, they are sensitive to deprivation and lack; inadequacy of food and air deprives them of their purpose and diminishes their power. Similarly, they are also vulnerable to that which is unfairly
withheld or unjustly taken from them: their cherished attachments,
whether to ideologies, values, expectations, or loved ones. To distinguish
between the two Organ Networks, the Spleen is wounded by disappointment and the Lung by loss. The Spleen worries about where the next reward is coming from, and the Lung pines for that which has come and gone.

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