Traditional Chinese Medicine and Mental Health Treatment

History and Origins of Traditional Chinese Medicine

Records show that Traditional Chinese Medicine (TCM) is more than 2,000 years old, although other written records date back 3,500 years earlier (Maclean and Shane 1999), and archaeological evidence suggests it began at least 5,000 years ago. Although called "traditional," TCM actually underwent a series of changes and adaptations in response to various influences — politics, economics, science, technology, and social and cultural shifts — to the point that Western medicine almost replaced it (Maclean and Shane), particularly following the fall of the Qing dynasty in 1911. TCM was restored and regained popularity only by the mid-1950s, and since then has continued to serve and benefit the Chinese people as well as the rest of the world.

TCM is founded on the concept of qi, the natural life force or energy that constitutes everything and everyone in the universe — humans, animals, plants, and even the elements. Condensed qi is matter; refined qi is spirit. Qi is produced in the body when food combines with inhaled air. The purpose of TCM is to introduce, restore, balance, or correct the presence of this life force in the body. TCM teaches that deficiency, blockage, or loss of qi accounts for fatigue, disease, poor physical or mental health, and ultimately death (Xi Yi Tang). Qi must circulate throughout the body through its channels or meridians for a person to be in perfect health.

Foundational Concepts: Qi, Yin-Yang, and the Causes of Disease

TCM also focuses on the balance between opposites in the universe — day and night, the sun and the moon, light and darkness, male and female. The Taoist symbols of yang and yin express this balance. A disturbance to that balance, whether external or internal, results in disease or discomfort when it occurs in the human body. TCM identifies the external causes of disease as the six evils: wind, cold, fire, damp, summer heat, and dryness. The internal causes are the seven effects: joy, anger, anxiety, thought, sorrow, fear, and fright. In some cases, TCM also attributes disease to miscellaneous causes such as injury, fatigue, exercise, and a person's physical constitution (Xi Yi Tang). TCM maintains that every disease arises from one or more of these causes or effects (Singler 1998), and that disease can in turn produce particular emotional states.

Practitioners claim that TCM can address even severe emotional and mental conditions — such as alcoholism, manic depression, schizophrenia, and eating disorders — which Western medicine finds difficult to treat (Singler). A further distinction from Western or conventional medicine is that TCM evaluates and treats the entire person, not just the localized bodily complaint, because its objective is the fullness and unity of the person's body, mind, and spirit.

Singler identifies five chief human emotions or mental states that give rise to disease and affect specific areas of the body: (1) fear and shock, which disturb the kidney and bladder meridians; (2) worry or over-contemplation, affecting the stomach and spleen meridians; (3) sadness or grief, affecting the lungs and large intestine meridians; (4) anger, frustration, or depression, affecting the liver and gallbladder meridians; and (5) over-excitement, affecting the heart and small intestine meridians (Singler). What makes TCM unique — and what has allowed it to survive — is its distinctiveness as an alternative to conventional, synthetic Western medicine, especially in the treatment of stress and other mental disorders. Unlike its conventional counterparts, TCM has no side effects, is non-addicting, is inexpensive, and treats accompanying signs and symptoms as effectively as the root causes (Singler). TCM makes use of natural treatment methods such as acupuncture, herbs, diet, massage, qi exercise, minerals, and animal products (Maclean and Shane).

Alcoholism is the unregulated, compulsive, and excessive physical and psychological dependence on alcoholic drinks that disturbs or damages a person's life or the lives of those around them. The person loses control over the habit, which adversely affects health, employment, and relationships. No single root cause has been isolated for this disorder, except "a genetic predisposition, which is activated by social and environmental stressors" (Allina 2002). When chronic and taken to the extreme, alcoholism injures the immune system, produces serious nervous, mental, and physical behavioral disorders, and can lead to cirrhosis and delirium tremens.

In complementing the benefits of joining organizations such as Alcoholics Anonymous, individuals can benefit from complementary and alternative approaches — including TCM — to reduce stress, make dietary adjustments, change lifestyle habits, and address secondary disorders with appropriate conventional medicine. Acupuncture stimulates acupoints in the ear to "restore the flow of chi (qi)" (Allina), helping control withdrawal symptoms and inducing relaxation. Biofeedback trains the person to regulate involuntary or unconscious biological processes through meditation, visualization, breathing, and muscle relaxation. These methods elicit a counter-response to stress and re-pattern the stress response, and are considered a significant treatment approach for alcoholism.

TCM Approaches to Mental Disorders

Chiropractic medicine aims at re-aligning the spinal column — including bones, muscles, and joints — with the nervous system through manual spinal manipulation. This has proved to be of supportive value in primary treatments of alcoholism (Allina). Guided imagery is a meditative technique through which the person with alcoholism can effectively adjust to withdrawal pains and other symptoms by focusing on a particular positive image, with the aim of translating it into physical reality. Herbal medicine can be used as a substitute for synthetic tranquilizers in controlling anxiety and restlessness. One example is St. John's wort, which has antidepressive action. Caution should, however, be observed regarding the possible risk of cross-addiction with some herbal preparations. Hypnotherapy employs hypnotic suggestion while the person is in a deeply relaxed state. It aims at reinforcing the desire to abstain from alcohol by making suggestions to the subconscious mind under hypnosis — a powerful behavior-changing tool. Hypnotherapy has been found useful in reducing relapse into alcohol use.

Massage is another stress-reducing and relaxing method that manipulates the soft tissues to restore normal health. It "stimulates blood circulation, relaxes tense muscles and aids the movement of lymph fluids which carry toxins out of tissues." This technique not only relaxes the body and mind but also induces the release of endorphins — the body's naturally produced pain-killers — for overall well-being (Allina). Meditation is a practice of calm concentration that gradually reduces the effects of external stimuli and produces a stress-free state and inner harmony. Individuals with alcoholism can benefit from daily meditation in regaining self-control, proper perspective, and sobriety (Allina).

Naturopathic medicine merges natural therapies collectively aimed at stimulating and enhancing the body's natural healing abilities. It includes dietary change, fasting, botanical medicine, homeopathic medicine, physical medicine, oriental medicine, psychological medicine, hydrotherapy, and relaxation techniques (Allina). It is holistic in that the whole person is treated by addressing the real root cause rather than merely managing symptoms and signs. The qigong method presents a regimen of "exercise, breathing and meditation" performed simultaneously to promote and optimize health and vigor (Allina). Practitioners attest to the effectiveness of daily qigong practice in reducing stress and fostering a sense of personal control.

Reiki addresses healing of body and spirit by energizing the body's molecules to restore total balance and harmony. Like the preceding methods, it is grounded in the belief that disease results from an imbalance in one's qi, and it is considered very useful in treating and rehabilitating individuals with alcoholism. Similarly, relaxation techniques can restore a lost sense of peace and stability, minimize tension, and help individuals cope with withdrawal symptoms. They can be practiced at home or anywhere that rest is needed or sobriety is required by a situation.

Spiritual healing and prayer underlie all of the above practices. The enhancement of belief in a higher power imparts a sense of hope, comfort, and peace — a foundation of Alcoholics Anonymous, practiced individually or as a group. The interaction between mind and body, along with trust in a power greater than oneself, is believed to activate the spiritual factors that effect recovery from compulsive behavior. Yoga is similarly useful, consisting of mental and physical training that instills unity between mind and body through posture work that releases tension and induces deep relaxation and inner harmony (Allina). Tai chi ch'uan likewise promotes exercise and meditation to foster a calm, clear spirit and inner harmony, while uniquely blending martial arts, meditation, and controlled breathing to develop "muscular strength, flexibility, posture balance and relaxation" (Allina).

A person with schizophrenia suffers from "distortion, extreme emotional sensitiveness, introversion, suspiciousness, manic attacks and fantasies" (Acupuncture.com). They find it difficult to think clearly, are incoherent, and are unable to express themselves adequately. Auditory and visual hallucinations also frequently occur. The condition is attributed to "genetic and environmental factors" along with emotional injury. Young adults are the most frequent victims of the disorder (Acupuncture.com).

The disorder begins with a first stage called depressive psychosis, in which the person begins to feel emotionally dejected and mentally dull. They become incoherent, mutter to themselves, and experience mood swings between laughter and crying. They lose appetite for food and become very sleepy (Acupuncture.com). The tongue develops a "white greasy coat" and the pulse becomes "wiry and slippery" (Acupuncture.com). The second stage, called manic psychosis, begins suddenly, with the person becoming irritable. The face and eyes become flushed, and the person experiences frequent headaches, insomnia, extreme restlessness, unusual physical strength, and violent or abusive behavior. The tongue turns "red with yellow greasy coating" and the pulse "wiry, slippery and rapid" (Acupuncture.com).

TCM treatment for schizophrenia consists of regulating the qi to alleviate depression, resolving phlegm, and calming the shen for the first stage (depressive psychosis). For the second stage (manic psychosis), treatment involves purging the fire, removing phlegm, tranquilizing the mood, and calming the shen.

Schizophrenia is also known in China as dian kuang, or the "madness syndrome" (Tof 1998), wherein the shen — the mind or consciousness — is in a state of confusion. The person loses "synchronization between inner energies and external mechanisms that influence those energies" (Tof), a dysfunction that results in the loss of ego boundaries. Practitioners perceive this as a consequence of dysfunction in the wei qi, a protective energy that also affects the immune system. Treatment of hallucinations, poor concentration, lack of vitality, and delusions in schizophrenia has involved a combination of acupuncture and herbal medicine.

The Chinese refer to depression as yuzheng, a condition in which the person has a greatly diminished zest for life. According to TCM, this is due to the stagnation of emotional and physical qi, which is largely stored in and associated with the liver, kidneys, and lungs. If the stagnation is chronic, the depression is severe (Hirsh). Other practitioners agree that depression is indicative of blocked liver energy. Treatment can take the form of two types of exercise: the first involving qigong warm-ups, and the second consisting of exercises to stimulate and tune up the whole biomechanical system of the body in order to relieve stress, maintain vitality, and promote general well-being (Hirsh). Treatment may also employ the Chinese herb curcuma (yu jin), which is believed to unblock obstructed liver energy. TCM practitioners collectively view depression as proceeding from deep and chronic emotions or thought patterns associated with anger and guilt.

TCM views eating disorders as occurring due to weakness of the spleen, which manifests as obsessive behavior (Tof). These are relatively recent conditions in cultures that place great emphasis on physical appearance and stigmatize being overweight. TCM practitioners see them as cases of abnormal appetite disturbance complicated by "psycho-emotional factors." The spleen is central to these conditions, since it "rules cognitive capacity, concentration and memorizing," as well as the "exercise of these pursuits and excess ruminations," which damage spleen functioning and lead to digestive troubles.

The most commonly known eating disorders today are anorexia nervosa and bulimia — the first being characterized by loss of appetite, and the second by overeating followed by purging through vomiting or laxatives, driven by guilt and self-condemnation. TCM practitioners consider these conditions manageable with a treatment combination of acupuncture and herbal medicine to re-establish digestive harmony (Tof).