Holistic Healing: Integrating Principles from Traditional Chinese Medicine with Psychotherapy
Traditional Chinese Medicine (TCM) has been practiced for over 2,500 years in various forms including herbal remedies, acupuncture, massage, exercise, and diet. In contrast to Western medicine, which treats symptoms and disease primarily in the body, TCM takes a holistic approach to treating the mind-body-spirit from a wellness perspective (Hammer, 2010). The focus is on cultivating a healthy internal harmony, and “the wise physician cures diseases before they develop, rather than after they manifest” (Cohen, 1997, p. 15). In this paper, I will give an overview of the general principles of TCM, go into a deeper dive on qigong energy healing, and discuss how TCM can be integrated with contemporary psychotherapy.
Diagnosis
In TCM, symptoms are interpreted as messages about how the patient’s inner state might be out of balance. All illness has spiritual implications, and all imbalances in the mind have manifestations in the body and vice versa (Hammer, 2010). Stress is the primary issue in disease, and in the modern world we are usually facing multiple stressors in our personal lives as well as the broader environment. Stress is internalized as muscular tension and causes our internal energies to flow sluggishly. When we are under constant stress, our nervous system copes by desensitizing; we may lose sensitivity to the feelings of others, create distance from others, and dull our senses with drugs, the internet, and television (Cohen, 1997). Physical symptoms can often actually develop in an attempt to keep the patient sane, which can be seen as an act of resilience. For instance, in response to complex trauma, a person might develop chronic headaches instead of going into psychosis, which may be much more debilitating (Hammer, 2010).
The TCM practitioner diagnoses the patient by looking, listening, asking, and touching. They will take the patient’s pulse, ask about the patient’s emotional state and stressors, and look at their face, tongue, coloring, posture, eyes, and hair. Different emotions are associated with different body systems: joy with the heart, anger with the liver, reflection with the spleen, sadness with the lungs, and fear with the kidneys. At first, imbalances might affect one organ system and may later spread to impact others if the underlying issues are not addressed. Different patients with the same symptoms can receive different diagnosis and treatments based on what is going on environmentally, emotionally, and behaviorally with them. According to TCM, for instance, the tongue can show digestion issues in the saliva coating. The stomach is involved not only in the digestion of food but also of thoughts and feelings. The small intestine separates the pure from the impure, and the large intestine eliminates bad thoughts, energy, and food. Psychological issues like holding onto repressed anger, anxiety, and stress in the patient’s life could have in impact on all of these organ systems and bodily functions. Each person has their own unique set of imbalances (Hammer, 2010).
Treatment Goals and Progress
In TCM, progress in treatment is not necessarily linear. If treatment is successful in one area, patients might start to re-experience old illnesses that are unresolved. The primary goal of acupuncture is to build awareness of how tension in the body is created through thoughts, emotions, and behaviors. Our pathologies usually involve an avoidance of living life in some way: “the depressed person who avoids both joy and responsibility for negative feelings; the obsessional person who avoids feeling by means of rigidity and orderliness;… the schizoid person who avoids feeling through detachment, the schizophrenic person who avoids terror through fragmentation; the paranoid person who avoids the unknown through projection” (Hammer, 2010, p. 16). These are all coping strategies that were the best the patient could do at the time to stay intact in response to early stressors. If a patient’s defense mechanisms are softened through the process of acupuncture, they may become aware of earlier trauma that they had been repressing. This earlier trauma might have an entirely different set of imbalances that manifest in the mind-body-spirit. Progress in healing is measured primarily by the patient’s mental state. If they are improving physically but emotionally getting worse, it’s an indicator that the treatment is not working. Health in TCM is conceptualized as a return to moving with nature and the body’s natural healing forces, whereas illness is some sort of violation of nature. The treatment allows the patient to become aware of how they are interfering with the flow of nature, and patients can prevent illness through knowledge and awareness of underlying causes (Hammer, 2010).
Working with Energy (Qi)
TCM is conceptualized around balancing qi, which is life energy or “the animating power that flows through all living things” (Cohen, 1997, p. 3). In health, qi is clear and flows smoothly. The sources of qi are the breath and food, which take dedication and regular practice to sustain, and constitution, which are inherited tendencies such as the health of parents, in utero care, and nature. The yin organs like the liver, heart, spleen, lung, and kidney store qi, while yang organs like the gallbladder, intestines, stomach, and bladder transport qi. Qigong is a set of self-healing exercises and meditations practiced daily to cleanse impure qi and fill with healing qi. According to TCM, the benefits of qigong are to increase the range of motion, improve stamina and coordination, help organs work more efficiently, strengthen the heart and digestive muscles, lower blood pressure, improve memory, increase blood flow, strengthen the immune system, lower metabolic rate, and improve biomarkers of aging (Cohen, 1997).
Qigong is practiced in alignment to nature. Qigong was first learned from observing planting and harvesting patterns in farming and by cultivating animal skills. The earliest exercises were recorded around 1,000 B.C. The two types of qigong are dynamic (movement in the body, stillness in the mind) and tranquil (stillness in the body, concentration in the mind). In the morning, the progression is from stillness to movement, whereas in the evening the practice starts with vigor and then winds down. In the spring, practitioners do exercises that open the body to energy in nature, whereas in the winter there is a focus on slowness and conservation of warmth. Different body parts also peak in their activity during different times of day, and thus practitioners have a different focus depending on when qigong is practiced (Cohen, 1997).
The standard qigong stance is that of active relaxation, which involves effortlessness and rootedness. The practitioner aims to use the minimum effort necessary to do any task. Even though this might seem like a simple concept, it’s actually quite profound. Throughout life, we learn how make an effort to do more, yet we often don’t learn how to do less. To lift a heavy object efficiently, for instance, effortlessness would mean being aware to not clench our facial muscles and use our quads rather than our back. Repressed emotions also create tension and stress in the body, and in practicing relaxation and tranquility in qigong, we can bring these tense areas into awareness. When we learn to relax the body, we also gain the capacity to be sensitive and open to other people. Foundational qigong teaches relaxation and sinking to the ground, standing like a tree, optimal breathing from the abdomen, walking meditation, and active, present-moment awareness of the mind through meditation. Qigong is an extensive and vast practice that can take a lifetime to master involving active poses that aim to heal different parts of the body, animal frolics to gain their attributes, visualizations of healing, energy work, and more (Cohen, 1997).
Integrating with Psychotherapy
Even though TCM is much more focused on the body than psychotherapy typically is, I think that many of its core principles align with how I already conceptualize my clinical work from psychodynamic and somatic theoretical frameworks. Early experiences and trauma can get stuck in the body and impact health, meaning making, and relationship dynamics later in life. We learn defenses and resiliency strategies that were the best we could do at the time but that may no longer serve us fully. Each person’s healing journey will also look different and will not be linear, as we discover, uncover, and recover the different parts of us that need healing. Building awareness is a central part of healing, and techniques such as acupuncture, relaxation, speaking, and present-moment awareness are all practiced in service of cultivating awareness. Emotions and stress are also held in the body, and working with them involves learning new embodied ways of being. TCM and psychotherapy can reinforce and support each other, especially if they are used together and inform each other in an integrative way.
Many of the foundational qigong practices are similar to mindfulness and somatic techniques that are used to settle the body and cultivate awareness. I’ve also used visualization exercises that are similar to qigong visualization with my patients who suffer from intense anxiety, and these exercises have helped reduce anxiety in the mind-body during session and allow my patients to slowly tolerate the difficult work of putting their fears and worries into words. Consistent practice of these techniques and exercises should have lasting impacts on the nervous system, help patients build awareness of their emotions and experiences in the body, and affect how patients relate to themselves and others.
The concepts of balance, harmony, and nature from TCM can also be helpful to integrate with psychotherapy. People who come from cultures that value individualism and autonomy often have a strong inner critic and tendency to blame themselves for things that might not go in accordance with their will. Helping these patients gain insights around interconnectedness and interdependence can help counterbalance these tendencies. The seemingly opposing energies of yin and yang, feminine and masculine, hot and cold, crane and bear, active and relaxed, and so forth coexist in a necessary balance in TCM (Cohen, 1997). This concept of opposing forces and contradictions, which exists in internal family systems and dialectical behavioral therapy, can help patients explore ambivalence and their own conflicting emotions and desires.
Personal Reflections and Conclusions
Before starting to understand TCM as a system, I was exposed to TCM through my mother and grandmother when I was a child. When I got a cold, they would ask me to take bitter herbal elixirs. When I got a nose bleed, they would say that I ate too many things that increased my internal heat. I thought these ideas were mostly superstitions, mainly because they didn’t seem to help, but now I see that these traditions were part of a larger system and conceptualization of health that found their way into mainstream Chinese culture. TCM should be practiced as an integrated part of one’s life in diet, exercise, and intentional practices. Going to acupuncture but maintaining an unhealthy diet or dulling the mind through substances and endlessly scrolling through social media probably won’t help much in overall well-being.
How we live and make sense of our personal lives come out in how we work with our clients and the theoretical models we are drawn to. I feel that the process of acculturation when my parents immigrated to the United States and re-education during the Cultural Revolution in China played a part in cutting me and many other Chinese people off from our culture of origin and healing practices that are thousands of years old. I feel committed to understanding, recovering, and integrating these practices into my life as a means of honoring where I come from and knowing myself better. This will influence my clinical work in ways that I might not be able to anticipate right now, and I’m excited to see how I might be able to use my own practices and experiences with TCM to support others in their own healing process.
References
Cohen, K. (1997). The Way of Qigong: The Art and Science of Chinese Energy Healing. Balantine Books.
Hammer, L. (2010). Dragon Rises, Red Bird Flies: Psychology & Chinese Medicine. Eastland Press, Inc.
