Psychiatry

[Guest guest]

on 10/1/00 10:42 AM, Todd at wrote:

Note: this book is focused on TCM psychiatry as it has actually been

practiced in china, which emphasizes herbs and acupuncture. According

to flaws, TCM does not have a developed tradition of talk therapy,

contrary to assertions made by Ted Kapchuk and some others. See BP

bulletin board at http://www.bluepoppy.com/ubb/Forum2/HTML/000002.html

to read a discussion of this topic and add your own thoughts.

 

 

 

Perhaps we should have Ted and Bob debate these points publically,

since both have access to the Chinese literature.

 

Perhaps in MODERN China, TCM psychiatry focuses on herbs and acupuncture

only. But I doubt this is true across this vast country, with many private

clinics not reporting into the official journals. However, in our

tradition, it clearly states in the Jia Yi Jing and Nei Jing that 'the

superior physician treats the spirit' (with the needle). It also speaks

about the intention of the practitioner, which means the mind and thoughts

of the practitioner. And, Chinese medicine clearly emphasizes lifestyle and

giving of advice to patients.

 

My own patients over the last twenty years come to receive not only

acupuncture and herbal medicine, but a safe environment where they can

speak, be themselves, and talk about the concerns of their health as related

to their lives. It is hardly a mechanical concern. Words are some of the

best healing tools we have, they are mentioned in the classical literature,

and to brush them off puts us back into the morass modern medicine finds

itself in, with 6.5 minutes average to spend with each patient, and no time

to communicate at any level.

 

 

[Guest guest]

on 10/1/00 11:14 PM, Todd at wrote:

 

>I would be delighted to see Mr. Kapchuk fully defend his position on this subject. Until then, I will >have to concur with Flaws' assessment, quoted below. We might otherwise ask whether the short lived prominence of the school of purgation (founded by zhang zi he), which claimed to successfully treat all disease with strong purging (through bowels, sweat and vomit) is enough justification to support the modern practice of nature curists, who all also embrace this idea.

 

I should note, that despite Dr. Zhang Zi-he's decreased status over the ages, some of his prescriptions have survived (a few are even in Bensky's " Formulas and Strategies " .. . .and a section of Zhang Zi-he's book is translated in " Rheumatology in " ). Also, counceling patients is hardly in the realm of purging them through bowels, sweat, and vomit. Then, again. . . ..

 

It is often pointed out that if this school was valid, then it would have remained prominent. The fact that it never achieved widespread professional support is often used as a reason by chinese herbalists to dismiss this approach to healing. Why doesn't the same standard apply to psychiatry?

 

Again, certain ideas have survived of Dr. Zhang's until the present. I would be careful about what we 'dismiss'. A Chinese student told me the other day that Li Dong-yuan's work was 'dismissed' among some of her colleagues. Also, remember in earlier CM (pre-Qing), the idea of specialties was less a priority than at present. The idea of 'psychiatry' was not a separate issue, nor was there any seeming bias against counceling patients, or observing the effects of the actual clinical encounter itself.

 

>Rather than brushing aside the role of talk therapy in TCM, I am rather asking for evidence to >>>support a modality that is already widely used by American practitioners as if it was a well documented part of traditional practice, when this does not appear to be the case. In my experience, psychoanalysis that continually stirs up emotions or dwells on childhood developmental issues is an impediment to healing most of the time, not an adjunct. Modern western culture puts way too much emphasis on how one " feels " ; I think this is one of our core social pathologies. I agree totally with the nei jing admonition on the importance of shen in healing, but from my perspective, most psychotherapy serves more to disturb the shen, then calm it.

 

Here, you've opened up a can of worms, and I am glad you did. The lack of clear criteria or standards in psychotherapy has served to diminish efficacy and standing in the public eye. I am quite aware of many of the excesses of the profession, and the incompetence, and the amount of money spent by patients with patently poor results. However, what we now call psychotherapy was in the realm of spiritual counceling in all traditions originally, from shamans to medicine men to rabbis and imams. It IS harder to quantify and codify these things, but they are important. For example, the Nei Jing talks about dream interpretation. Jungian psychology does as well. It is an important part of life, and should not be ignored.

 

I agree that there are dangers and abuses in modern psychotherapy. The constant stirring up of childhood and developmental issues can be more abusive than therapeutic.

 

(Todd) So I use herbs and acupuncture to regulate qi and shen; I counsel patients about behavior, including the role of emotions in disease; and when they are ready, I advise practices that reinforce this position, such as qigong or other forms of yoga and meditation. A note of caution though is that patients who are mentally imbalanced will often worsen from qi gong if this therapy is introduced prematurely.

 

Well, then, there you go. The Classic of Categories/Lei Jing by Zhang Jie-bin has a few chapters on the subject of emotions and their influence on health. As part of my medical Chinese study group, we have translated the material, and it sounds pretty 'psychological' to me. The influence of emotions on the five yin viscera is an established subject in Chinese medicine for millenia. . .how can one possibly diminish this influence in Chinese medicine without diluting the subject matter?

 

 

 

Flaws says (from http://www.bluepoppy.com/ubb/Forum2/HTML/000002.html),

 

" Further, I also think it is extremely important for students and practitioners to have

direct, personal access to a wider selection of Chinese medical literature. For instance,

Ted Kaptchuk, in his Preface or Introduction to Acupuncture in Practice, mentions Wu

Kun's " Medicine Without Form " and Wu Ju-tong's use of the so-called " Divine Method of

Incantation, " both putative systems of Chinese psychotherapy. Reading Ted's

reference to these, one might be tempted to think that these premodern methods

were widely used, or that the premodern existence of these methods implies some

deficiency within modern Chinese medicine. (italics mine: TL)

 

Personally, I don't know if they were or were not widely used during their time. But

before I hold them out as evidence of the existence of premodern Chinese medical

psychotherapy and, even further, use them as examples of something lacking in

modern practice, I need to find out more about them. First I need to read what Wu

Kun and Wu Ju-tong had to say for themselves, not just Ted's passing reference to

them. Then I need to read what other Chinese doctors have said about what Wu and

Wu said. Then I have to answer the question, " What happened to these

methodologies over time? " If they are no longer considered a part of standard

professional Chinese medicine, why not? If they truly provided some necessary,

extremely valuable service to consumers of professional Chinese medicine (which I am

not saying they did not), why then do they appear to have died out within professional

Chinese medicine? "

 

While I do have sympathy with much of what Bob is saying here, and great respect for his ideas, I have had, personally, long conversations with Ted about what he feels is the 'somatizing of Chinese medicine', the deliberate attempt to reframe Chinese medicine in mainland China. It may be that the jury is still out on this subject. . . .we shouldn't come to ANY conclusions about where classical Chinese medicine stands on the issue of psychotherapy, in any direction, without more research into the classical literature, and hearing the input of practitioners and scholars from the different schools of thought in our medicine.

 

When Bob asks why do these methodologies appear to have died out in professional Chinese medicine, perhaps another way to phrase the question would be.. . .(from my point of view). . ..what social, political and economic issues in modern China contributed to this diminishing role of mind and emotion in modern Chinese medicine? Is this state of affairs desirable for the practice of CM in the West? Are we getting the full story in the journals? What agendas are being followed here? I don't think only efficacy or practicality is the issue here. We must remember that any discourse of a spiritual or religious nature is highly suspect in Mainland China today at an official level.

 

Ah, I opened another can of worms.

 

Any other opinions out there?

 

 

[Guest guest]

>>>I visited one psychiatric hospital and most of the patients were DRUGGED out of their minds with heavy sedatives like thorazine American country music was playing overhead.

Alon

 

-

 

Sunday, October 01, 2000 8:08 PM

Re: psychiatry

on 10/1/00 10:42 AM, Todd at wrote:Note: this book is focused on TCM psychiatry as it has actually beenpracticed in china, which emphasizes herbs and acupuncture. Accordingto flaws, TCM does not have a developed tradition of talk therapy,contrary to assertions made by Ted Kapchuk and some others. See BPbulletin board at http://www.bluepoppy.com/ubb/Forum2/HTML/000002.htmlto read a discussion of this topic and add your own thoughts.Perhaps we should have Ted and Bob debate these points publically,since both have access to the Chinese literature.Perhaps in MODERN China, TCM psychiatry focuses on herbs and acupunctureonly. But I doubt this is true across this vast country, with many privateclinics not reporting into the official journals. However, in ourtradition, it clearly states in the Jia Yi Jing and Nei Jing that 'thesuperior physician treats the spirit' (with the needle). It also speaksabout the intention of the practitioner, which means the mind and thoughtsof the practitioner. And, Chinese medicine clearly emphasizes lifestyle andgiving of advice to patients.My own patients over the last twenty years come to receive not onlyacupuncture and herbal medicine, but a safe environment where they canspeak, be themselves, and talk about the concerns of their health as relatedto their lives. It is hardly a mechanical concern. Words are some of thebest healing tools we have, they are mentioned in the classical literature,and to brush them off puts us back into the morass modern medicine findsitself in, with 6.5 minutes average to spend with each patient, and no timeto communicate at any level.Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

Cognitive therapy can be of great help. I often recommend the book feeling good. One does not dwell on psychoanalysis with it

alon

 

-

cha

Sunday, October 01, 2000 11:14 PM

psychiatry

I would be delighted to see Mr. Kapchuk fully defend his position on this subject. Until then, I will have to concur with Flaws' assessment, quoted below. We might otherwise ask whether the short lived prominence of the school of purgation (founded by zhang zi he), which claimed to successfully treat all disease with strong purging (through bowels, sweat and vomit) is enough justification to support the modern practice of nature curists, who all also embrace this idea. It is often pointed out that if this school was valid, then it would have remained prominent. The fact that it never achieved widespread professional support is often used as a reason by chinese herbalists to dismiss this approach to healing. Why doesn't the same standard apply to psychiatry? Rather than brushing aside the role of talk therapy in TCM, I am rather asking for evidence to support a modality that is already widely used by American practitioners as if it was a well documented part of traditional practice, when this does not appear to be the case. In my experience, psychoanalysis that continually stirs up emotions or dwells on childhood developmental issues is an impediment to healing most of the time, not an adjunct. Modern western culture puts way too much emphasis on how one "feels"; I think this is one of our core social pathologies. I agree totally with the nei jing admonition on the importance of shen in healing, but from my perspective, most psychotherapy serves more to disturb the shen, then calm it. So I use herbs and acupuncture to regulate qi and shen; I counsel patients about behavior, including the role of emotions in disease; and when they are ready, I advise practices that reinforce this position, such as qigong or other forms of yoga and meditation. A note of caution though is that patients who are mentally imbalanced will often worsen from qi gong if this therapy is introduced prematurely. Flaws says (from http://www.bluepoppy.com/ubb/Forum2/HTML/000002.html), "Further, I also think it is extremely important for students and practitioners to have direct, personal access to a wider selection of Chinese medical literature. For instance, Ted Kaptchuk, in his Preface or Introduction to Acupuncture in Practice, mentions Wu Kun's "Medicine Without Form" and Wu Ju-tong's use of the so-called "Divine Method of Incantation," both putative systems of Chinese psychotherapy. Reading Ted's reference to these, one might be tempted to think that these premodern methods were widely used, or that the premodern existence of these methods implies some deficiency within modern Chinese medicine. (italics mine: TL) Personally, I don't know if they were or were not widely used during their time. But before I hold them out as evidence of the existence of premodern Chinese medical psychotherapy and, even further, use them as examples of something lacking in modern practice, I need to find out more about them. First I need to read what Wu Kun and Wu Ju-tong had to say for themselves, not just Ted's passing reference to them. Then I need to read what other Chinese doctors have said about what Wu and Wu said. Then I have to answer the question, "What happened to these methodologies over time?" If they are no longer considered a part of standard professional Chinese medicine, why not? If they truly provided some necessary, extremely valuable service to consumers of professional Chinese medicine (which I am not saying they did not), why then do they appear to have died out within professional Chinese medicine? " -- Director Chinese Herbal Medicine Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

There are a couple of other things here. Because Chinese people tend not

to forget the past (most Americans had a break with their ancestry

100-400 years ago) and because many Chinese live a " village

life " (this includes the " work unit " ) where past scores

are not forgotten, of course it is more prudent to keep quiet. Modern

Chinese remember the Cultural Revolution where people were encouraged to

speak up and millions got screwed or killed because of it. Many people

who were denouncing and denounced in the C.R. ended up working together

after it. I had a friend translate " gossip " into her native

Chinese. By the look on her face, it had a much deeper meaning for her

than me.

I think this is why so many Chinese make any doubt or unhappiness as

" liver qi stagnation " , the inability to flow in ones

culture.

 

Face it, individuality is not good for the collective.. ;-)

 

 

At 12:47 PM 11/2/00 -0800, you wrote:

I know people in

China, not a few but many who are young adults

and middle aged who were simply raised with the

understanding

that it's best not to say anything. Again, this

is not merely a

modern affect. Confucius pointed out that one

wrong word can

bring down the whole country. And the virtue of

silence has

been celebrated...and practiced by Chinese for

milennia. But whatever the

reasons, when a parent trains a child into

silence, it leaves

an indellible impression. And the word not

spoken is devilishly

difficult to understand, let alone

analyze.

L.Ac.

acupuncture & herbs

safe, compassionate care

 

1823 Wilshire Blvd. #610

Santa Monica, CA

90403

310 264-9197

[Guest guest]

How do you prevent the whole message from reappearing when you reply

thanks

alon

 

-

cha

Sunday, October 01, 2000 10:42 AM

psychiatry

The blue poppy psychiatry link is online athttp://chinesemedicalpsychiatry.com/Note: this book is focused on TCM psychiatry as it has actually beenpracticed in china, which emphasizes herbs and acupuncture. Accordingto flaws, TCM does not have a developed tradition of talk therapy,contrary to assertions made by Ted Kapchuk and some others. See BPbulletin board at http://www.bluepoppy.com/ubb/Forum2/HTML/000002.htmlto read a discussion of this topic and add your own thoughts.--DirectorChinese Herbal Medicinehttp://www..orgChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

Two choices, (1) usually there is a setting where you can choose not to have message you're replying to appear. ( in Outlook Express it's under Tools, then click on Options, then click on Send). Then you have to cut and paste anything you want to keep.

 

Or, you manually delete the old message.

 

Catherine

 

 

-

alonmarcus

Saturday, October 07, 2000 9:04 AM

Re: psychiatry

 

How do you prevent the whole message from reappearing when you reply

thanks

alon

 

-

cha

Sunday, October 01, 2000 10:42 AM

psychiatry

The blue poppy psychiatry link is online athttp://chinesemedicalpsychiatry.com/Note: this book is focused on TCM psychiatry as it has actually beenpracticed in china, which emphasizes herbs and acupuncture. Accordingto flaws, TCM does not have a developed tradition of talk therapy,contrary to assertions made by Ted Kapchuk and some others. See BPbulletin board at http://www.bluepoppy.com/ubb/Forum2/HTML/000002.htmlto read a discussion of this topic and add your own thoughts.--DirectorChinese Herbal Medicinehttp://www..orgChinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education. Chinese Herbal Medicine, a voluntary organization of licensed healthcare practitioners, matriculated students and postgraduate academics specializing in Chinese Herbal Medicine, provides a variety of professional services, including board approved online continuing education.

[Guest guest]

You should be able to erase all but pertinent information by standard

word processing methods in your reply.

 

Also can I ask that people pay attention to the date on your

computer. If it is not correct, then it shows up in weird places in

others e-mail programs. eg: Ken Rose - who once again proves

that he is ahead of his time ;-)

 

 

At 09:04 AM 10/7/00 -0700, you wrote:

How do you prevent

the whole message from reappearing when you reply

thanks

alon

 

 

L.Ac.

acupuncture & herbs

safe, compassionate care

 

1823 Wilshire Blvd. #610

Santa Monica, CA

90403

310 264-9197

[Guest guest]

, " " <

zrosenberg@e...> wrote:

> on 10/1/00 11:14 PM, Todd at @i... wrote:

 

>

> I should note, that despite Dr. Zhang Zi-he's decreased status over

the

> ages, some of his prescriptions have survived (a few are even in

Bensky's

> " Formulas and Strategies " .. . .and a section of Zhang Zi-he's book

is

> translated in " Rheumatology in " ).

 

I knew you were going to say this and my original post even included

a

final note to this effect, but I deleted it. these formulas are now

used for a limited range of complaints, though. admittedly, acute

mental disorder being among them. and I have no problem with acute

symptomatic talk therapy, like preventing harm to oneself or others,

for example. I just question the role of this method in chronic

illness, despite the new age proclivity to see mind as foremost (such

as the Louise Hay school of thought), rather than merely integral.

 

Also, counceling

> patients is hardly in the realm of purging them through bowels,

sweat, and

> vomit. Then, again. . . ..

 

again, I am not talking about counseling, I am talking about

psychoanalysis, which are quite different things. And actually think

much psychoanaysys, including modern past life regression and

recovered

memories methods are quite analogous to purging. In fact, the term

catharsis is often used to describe the results of this method

 

 

However, what we now call

> psychotherapy was in the realm of spiritual counceling in all

traditions

 

I don't agree. Psychotherapy is focused on stabilizing the ego. It

is

most appropriate when the patient has not developed a stable ego. I

think the spiritual is another level of consciousness beyond

sensation,

emotion and thought. I am very influenced by the work of Ken Wilber

in

this area, summarized at http://www.imprint.co.uk/Wilber.htm

 

traditional cultures develop stable egos in their members through

instilling cultural precepts about ways to behave, etc. Modern

society

does not instill any such tried and true precepts, thus many folks

are

left to their own devices. This anything goes mentality is very

destabilizing to the ego, but it really has little to do with one's

toilet training, for example. At any point, a person can decide to

straighten up and fly right. Ego development is a natural process,

which proceeds unimpeded in the right environment. I see this

developmental process as a natural expression of essence and qi

transformations, so it may be best facilitated by methods that

address

these factors directly, like herbs and acupuncture, rather than

fragmented approaches that deal with the mind as if it is separate

from

body. that is the inherent problem with psychotherapy. It is

reductionistic. Qi is a holistic ooncept that integrates body, mind

and spirit and when we focus on qi, everything comes into place.

 

If talk therapy could be assessed according to bianzheng parameters,

then I would be singing a different tune. but mostly people approaxh

it as if one size fits all. So we have the recovered memory folks,

the

jungians, the gestaltists, the freudians, the family therapists, all

of

who believe their method is a universal panacea. but it only seems

to

reason that some therapies would be more appropriate for different

constitution types. If we are not choosing our psychotherpies to

disperse excess and supplement vacuity, then how can we claim to be

adhering to the tenets of TCM. for example,a vacuous patient with

scattered shen perhaps won't benefit from psychotherapies that

further

disperse the mind, such as free association, while those with mature

ego structures types may not benefit from accentuating this aspect of

consciousness, such as through transactional analysis.

 

 

 

>

> I agree that there are dangers and abuses in modern psychotherapy.

The

> constant stirring up of childhood and developmental issues can be

more

> abusive than therapeutic.

 

and despite the disprepute for methods that seek to do this within

modern psychiatry, they are quite embraced by many within our field,

because they are part of pop psychology and in the absence of

evidence,

folks always gravitate this way.

 

 

The influence of

> emotions on the five yin viscera is an established subject in

Chinese

> medicine for millenia. . .how can one possibly diminish this

influence in

> Chinese medicine without diluting the subject matter?

 

People have written lots of things. some work, others don't. It is

the test of time that validates modalities. for instance, the

vietnamese, koreans, tibetans and japanese all adapted the principles

of TCM to their cultures through the eras, resulting in different

developments in different palces (such as abdominal dx in japan). Of

these, only the tibetans have what might be called a prominent

psychiatric tradition and this tradition is decidedly different from

modern talk therapy (it is also much more derived from buddhism and

ayurveda than TCM).

 

>

> While I do have sympathy with much of what Bob is saying here, and

great

> respect for his ideas, I have had, personally, long conversations

with Ted

> about what he feels is the 'somatizing of Chinese medicine', the

deliberate

> attempt to reframe Chinese medicine in mainland China.

 

yet unlike Bob, Ted has not provided any substantial evidence to

support his conjecture. the works of zhu dan xi, li dong yuan and

zhang zhong jing all already reflected this so called somaticization

and it appears that Ted has had to dig deep far and deep to find the

few obscure passages upon which he hangs his thesis

 

It may be that the

> jury is still out on this subject. . . .we shouldn't come to ANY

conclusions

> about where classical Chinese medicine stands on the issue of

psychotherapy,

 

 

I think the existing evidence is so everwhelmingly in Bob's favor,

that

it is hard to imagine anyone could unearth anything that would

seriously challenge this. But I always bow to evidence, so my mind

can

be changed by a preponderance. Lest anyone get the wrong impression,

I

was once an advocate of the approach I now descry and even seriously

considered studying counseling psychology formally. but professional

experience and historical evidence has led me down another path.

 

>

..what social, political and

> economic issues in modern China contributed to this diminishing

role of mind

> and emotion in modern Chinese medicine?

 

this is not a modern phenomena, but part of confucian culture, as I

understand it. I think Ken undescores this.

 

todd

[Guest guest]

, Catherine Hemenway <

chemenway@b...> wrote:

..

>

> Or, you manually delete the old message.

 

and you manually delete the old message by moving the mouse cursor

over

the part you want to delete, which should highlight that part. then

just press delete.

 

todd

>

[Guest guest]

on 10/7/00 11:16 AM, at wrote:

 

 

> However, what we now call

>> psychotherapy was in the realm of spiritual counceling in all

> traditions

>

> I don't agree. Psychotherapy is focused on stabilizing the ego. It

> is

> most appropriate when the patient has not developed a stable ego. I

> think the spiritual is another level of consciousness beyond

> sensation,

> emotion and thought. I am very influenced by the work of Ken Wilber

> in

> this area, summarized at http://www.imprint.co.uk/Wilber.htm

 

 

I am also a fan of Ken Wilber's work. . . .he is truly a renaissance person

of the age.

 

My definition of psychotherapy is simply giving good timely advice to help

another through a rough spot in life and grow, not professional taking apart

the psyche in arbitrary categorizations. A lot of times, people pay

therapists to provide what their parents, mates, and significant others do

not take the time to do. . . .talk and help them through difficult spaces.

>

> traditional cultures develop stable egos in their members through

> instilling cultural precepts about ways to behave, etc. Modern

> society

> does not instill any such tried and true precepts, thus many folks

> are

> left to their own devices. This anything goes mentality is very

> destabilizing to the ego, but it really has little to do with one's

> toilet training, for example. At any point, a person can decide to

> straighten up and fly right. Ego development is a natural process,

> which proceeds unimpeded in the right environment. I see this

> developmental process as a natural expression of essence and qi

> transformations, so it may be best facilitated by methods that

> address

> these factors directly, like herbs and acupuncture, rather than

> fragmented approaches that deal with the mind as if it is separate

> from

> body. that is the inherent problem with psychotherapy. It is

> reductionistic. Qi is a holistic ooncept that integrates body, mind

> and spirit and when we focus on qi, everything comes into place.

 

Certainly no disagreement here. It is all a matter of definition. I don't

believe in a mind separate from body either. . . and treatment with herbs

and acupuncture is highly therapeutic. But sometimes words can help. As

Bob quotes Cheng Dan-an on a similar discussion on the Blue Poppy website:

" According to the teachings of my late father and my own clinical

experience, the effects of needling lie mainly in three points: first, the

psychological interaction (between patient and practitioner), seceond,

concentration, and third, physical stimulation. It is the combination of

these three that works instantaneous wonders. "

>

> If talk therapy could be assessed according to bianzheng parameters,

> then I would be singing a different tune. but mostly people approaxh

> it as if one size fits all. So we have the recovered memory folks,

> the

> jungians, the gestaltists, the freudians, the family therapists, all

> of

> who believe their method is a universal panacea. but it only seems

> to

> reason that some therapies would be more appropriate for different

> constitution types. If we are not choosing our psychotherpies to

> disperse excess and supplement vacuity, then how can we claim to be

> adhering to the tenets of TCM. for example,a vacuous patient with

> scattered shen perhaps won't benefit from psychotherapies that

> further

> disperse the mind, such as free association, while those with mature

> ego structures types may not benefit from accentuating this aspect of

> consciousness, such as through transactional analysis.

 

Absolutely. Rather than reject psychotherapeutic methods outright, let's

try to understand of all the many therapeutic methods on this planet, which

are applicable to our patients by applying yin/yang theory and pattern

diagnosis. I'm sure Ken Wilber would be proud.

>

>

>

>>

>> I agree that there are dangers and abuses in modern psychotherapy.

> The

>> constant stirring up of childhood and developmental issues can be

> more

>> abusive than therapeutic.

>

> and despite the disprepute for methods that seek to do this within

> modern psychiatry, they are quite embraced by many within our field,

> because they are part of pop psychology and in the absence of

> evidence,

> folks always gravitate this way.

 

There is pop psychology, and. . . .. pop acupuncture, pop herbalism,

unfortunately.

>

>

> The influence of

>> emotions on the five yin viscera is an established subject in

> Chinese

>> medicine for millenia. . .how can one possibly diminish this

> influence in

>> Chinese medicine without diluting the subject matter?

>

> People have written lots of things. some work, others don't. It is

> the test of time that validates modalities. for instance, the

> vietnamese, koreans, tibetans and japanese all adapted the principles

> of TCM to their cultures through the eras, resulting in different

> developments in different palces (such as abdominal dx in japan). Of

> these, only the tibetans have what might be called a prominent

> psychiatric tradition and this tradition is decidedly different from

> modern talk therapy (it is also much more derived from buddhism and

> ayurveda than TCM).

>

>>

>> While I do have sympathy with much of what Bob is saying here, and

> great

>> respect for his ideas, I have had, personally, long conversations

> with Ted

>> about what he feels is the 'somatizing of Chinese medicine', the

> deliberate

>> attempt to reframe Chinese medicine in mainland China.

>

> yet unlike Bob, Ted has not provided any substantial evidence to

> support his conjecture. the works of zhu dan xi, li dong yuan and

> zhang zhong jing all already reflected this so called somaticization

> and it appears that Ted has had to dig deep far and deep to find the

> few obscure passages upon which he hangs his thesis.

 

My perception of Dr.s' Li, Zhu and Zhang Ji do reflect relative

somaticization, however, I also think the present-day Chinese society has

further somatized the practice of medicine, at least at an official level.

Let's not forget that.

>

> It may be that the

>> jury is still out on this subject. . . .we shouldn't come to ANY

> conclusions

>> about where classical Chinese medicine stands on the issue of

> psychotherapy,

>

>

> I think the existing evidence is so everwhelmingly in Bob's favor,

> that

> it is hard to imagine anyone could unearth anything that would

> seriously challenge this. But I always bow to evidence, so my mind

> can

> be changed by a preponderance. Lest anyone get the wrong impression,

> I

> was once an advocate of the approach I now descry and even seriously

> considered studying counseling psychology formally. but professional

> experience and historical evidence has led me down another path.

>

 

I don't know. . . ..I don't get the impression of overt somatization when I

read the Nan Jing, Jia Yi Jing or Shen Nong Ben Cao.

 

This is a good discussion. But I don't want to give the impression that I

am into indulging patients' to an extreme with their feelings. Again, it is

down to true compassion, not pop psychology. It is about showing real

concern for suffering, real compassion (which means not indulging emotions,

but reflecting to patients what can be helpful and healing) and being a

mensch, ultimately. Yes, that's it. In the end, it's about being a mensch.

 

 

[Guest guest]

I don't think it's important how many Chinese are currently in talk

therapy; that's only an interesting question for historians or

sociologists, not practitioners of Chinese medicine in American. The

answer will be of a statistical character---without moral or

procedural implications for our profession.

 

But, it attracts our attention because it is part of the larger

question of how Chinese medicine will fit into American life. Most of

which will be decided ultimately by market forces and general

cultural adaptations.

 

I feel it is more interesting for us to consider how we can analyze a

patient's emotional life and see how it bears on their physical

health. In most cases, our methodologies (acupuncture and herbs) can

do as much, if not more than, Western pharmaceuticals to explain and

resolve a condition. While Western medicine has only recently come to

see the connection between body and mind (for example, in recent

studies on stress, infant neurobiology, and psychneuroimmunology), it

has been an inherent part of 5-Elements since the beginning. Methods

such as pulse diagnosis and 5-Element differential diagnosis that can

distinguish the emotional aspects of a problem from the physical are

already part of our system.

 

When it's available, the Blue Poppy book should be an interesting

survey of the past Chinese literature, and a welcome edition to the

body of work already in English that includes books like Larre and

Rochat's SEVEN EMOTIONS (Monkey Press) and Thomas Dey's SOOTHING THE

TROUBLED MIND (Paradigm Press).

 

Does anyone employ acupuncture and herbs for psychological problems?

Or treat the psychological aspects of physical disorders?

 

I can give an interesting case history to illustrate my point. One

student in my last pulse class brought in a 50ish-woman who had

suffered from frequent migraines since college. During her history of

migraines, she had tried all of the remedies available and got only a

little relief from Immatrex. From the TCM point of view, she had many

of the common symptoms associated with migraines created by liver

blood insufficiency engendering wind, and liver qi counterflowing.

The student had done some acupuncture on her and provided more relief.

 

Examining her pulses, I found an interesting situation. There was a

peculiar, very deep connection between the right proximal and right

middle positions. This pattern is evident in people who do not

receive adequate emotional nurturing at an early age and into

adolescents. Deep in the left proximal position, there was evidence

of chronic insecurity. What was interesting and unique to her was the

way the pulse connected from the left proximal into the left middle.

It bifurcated or split, one part going from the proximal up into the

upper left middle, and the other part going from the proximal down

into the deeper left middle. And the connection from the liver to the

heart was blocked (evidence of shen protecting itself).

 

From her pulses, I could see that the emotional patterns she had

developed when young were always recreating the yin and liver blood

insufficiency, depressing liver qi, and causing spleen vacuity. Any

time she was under stress, the condition would become hyperactivity

of liver yang, and the headaches would be triggered or worsen.

Without addressing the emotional aspect of her condition, it would be

like bailing water from a boat with a hole in it.

 

After examination, when asked about her childhood, she said that she

was one of seven children and she described her mother as emotionally

unavailable and unresponsive (but not physically abusive). When she

was in college, her mother died unexpectedly and without warning. The

relationship between her and her mother---tentative though it was---

was lost and could never be mended or resolved. The worry and fear

(earth and water respectively) a child goes through can create a

physiological pattern that can have repercussions years later (wood

and shen) as stress increases and accumulates in adult life, and the

qi and blood levels diminish with age (for example, as discussed in

the first chapter of the Suwen).

 

As I mentioned in a previous posting, we know from recent studies in

neurobiology that emotion is not limited to some specifically

designed circuits of the brain that were once thought to be

the " center " of emotion. Emotions are nonconscious mental processes,

and are a fundamental part of the information processing and energy

flow that are central features of the organization of the self.

Emotions are an essential way that the brain integrates and organizes

itself and, in turn, the rest of the body. As such, emotions are

important for us to consider in clinical practice. Emotion changes

physiology, physiology changes physical structure. While 5-Elements

cannot get into specific neurological detail as Western science, it

has anticipated the connections between mind and body and can

organize these details at a theoretical and behavioral level.

 

Jim Ramholz

[Guest guest]

, " James Ramholz "

<OMJournal@m...>

wrote:

> I don't think it's important how many Chinese are currently in talk

> therapy; that's only an interesting question for historians or

> sociologists, not practitioners of Chinese medicine in American.

The

> answer will be of a statistical character---without moral or

> procedural implications for our profession.

 

it is only interesting to me whether it can be documented that talk

therapy EVER played a prominent role in TCM, which I think is

doubtful. as to whether modern western psychology is growing in

china,

thats something completely different, which I agree has no bearing on

our

pratice,at least no more than the fact that western medicine is the

most prominent modality in modern china.

 

>

> But, it attracts our attention because it is part of the larger

> question of how Chinese medicine will fit into American life. Most

of

> which will be decided ultimately by market forces and general

> cultural adaptations.

 

however if we allow market forces to lead the uninformed down the

road of pop psychology, as if there was truly some intersection

between

TCM and such ideas, we are in for trouble. another reason to get as

much authentic info transmitted from china as possible before the

self

help salesmen fill the void with their propaganda.

 

>

> Does anyone employ acupuncture and herbs for psychological

problems?

> Or treat the psychological aspects of physical disorders?

 

Not as isolated from the whole pattern. what are called psych

disorders or psych aspects of physical disorders I invariably find to

be part and parcel of entire symptom complexes which must be treated

as such to achieve success.

 

The worry and fear

> (earth and water respectively) a child goes through can create a

> physiological pattern that can have repercussions years later (wood

> and shen) as stress increases and accumulates in adult life, and

the

> qi and blood levels diminish with age (for example, as discussed in

> the first chapter of the Suwen).

 

how did you treat this? with herbs/acu or talk therapy. I totally

agree this is vital info to ascertain, but just not to act upon with

psychoanalysis. the trick is getting it without inadvertently

intitiating a psychotherapy session, especially in patients inclined

to

catharsis.

 

 

Emotions are nonconscious mental processes,

> and are a fundamental part of the information processing and energy

> flow that are central features of the organization of the self.

> Emotions are an essential way that the brain integrates and

organizes

> itself and, in turn, the rest of the body. As such, emotions are

> important for us to consider in clinical practice. Emotion changes

> physiology, physiology changes physical structure.

 

I totally agree with this and I hope I haven't given another

impression. It is the self indulgent dwelling on emotions that is

pathological, not the healthy experience of emotions. I think TCM

inherently recognizes this, as James say of the five phases.

 

[Guest guest]

Z'ev,

 

My experience with the subject is rather limited, but I can

tell you a story. In 1993 I met a professor of psychology

named Zhang who taught at that time at Chengdu University,

not the medical university, the City University. He taught

Transactional Analysis and counseled students as well as

private patients, i.e. other than students. He was an advisor at a private

English training academy where I did some teaching,

so we got to know each other a bit. On several occasions

he gave me "demonstrations" of how he conducted his

interviews with patients. It wasn't exactly what I'd call

talking therapy. He was a good listener and I notcied

that people he talked to tended to feel understood.

 

But the therapy consisted essentially of him hearing

what was wrong and advising the patient to be a better

person. He explained to me that this wasn't exactly

in keeping with the theories of Transactional Analysis

but that he had adapted its principles to the Chinese

circumstance.

 

Your question is really a question about the Chinese

circumstance.

 

People over the age of 25 or 30 in China have

spent much of their lives experiencing and getting over

one of the most profound social crises in modern

human history, the Great Proletarian Cultural Revolution.

 

The carnage of individuals and social structures was

widespread and thorough during this ten year series of

paroxysms. It came at the end of six decades which

witnessed the violent deaths of approximately 100 million

Chinese people.

 

It has now been followed by two and a half decades of

what is one of if not the most rapid economic and social

expansion ever witnessed on earth.

 

Without getting into the complexities of the interrealted

dynamics of individuals and their societies, I don't think

it's too much of a leap to conclude that the Chinese people

have been stressed out.

 

Moreover, they live in a social/political environment that does not

contain the same safeguards of personal expression that we

take for granted in the States and other Western cultures. I

point out here that these are not simply ideological differences

bewteen China and the West but manifestations of long-standing

cultural patterns.

 

I know people in China, not a few but many who are young adults

and middle aged who were simply raised with the understanding

that it's best not to say anything. Again, this is not merely a

modern affect. Confucius pointed out that one wrong word can

bring down the whole country. And the virtue of silence has

been celebrated...and practiced by Chinese for milennia. But whatever the

reasons, when a parent trains a child into silence, it leaves

an indellible impression. And the word not spoken is devilishly

difficult to understand, let alone analyze.

 

Speaking of words, underlying any such comparative study

of psychotherapy East and West is a stratum of issues that

once again evoke the discussion of terminology. I submit that

the traditional Chinese notions of "mind,spirit," and other

fundamental terms used to describe and discuss

psychology in the West are substantially different

than their English (as well as other Western language)

cognates. Therefore, readers of English language texts

on this subject (not to mention writers) find themselves

in a field that is heavily booby trapped with apparently

similar meanings that are, on closer examination, significantly

different. There is a reason to harp on the issues of

terminology, translation, standards, quality, etc.: we

cannot escape them.

 

Not even...ESPECIALLY NOT EVEN when considering

the meaning of psychological concepts and how they

do and/or should impact on contemporary clinical practice.

 

Ken

[Guest guest]

Mel, I finally read the article you posted regarding psychiatry not

being a science. I could go on and on about that article, but I will

try to stay brief (I have a short attention span, I always think

others do as well).

 

First -- some things I agree with what you eat (or don't eat) is more

important than many folks realize (except people who frequent this

site and others like it). Sugar is bad, etc. Certainly foods can

play a part in any illness and should always be considered.

 

Yes, pharmaceutical companies hawk their wares -- most companies hawk

their wares and this should come as no big surprise. They have

millions and millions of dollars tied up in research and development

and getting through the whole FDA process. This is the reality of

business. They are not creating things just to fool everyone with

bogus stuff to make a profit. Yes, like any business, they want to

make a profit (wouldn't you?).

 

However, they are responding to people and family members who are in

mental pain and completely at a loss as to what to do.

 

Now days people tend to look for quick fixes: take a pill and it all

goes away. We are all in a hurry. Nothing wrong with that, totally

human. Learning patience is a task we all have to go through.

 

Nope, psychiatry is not an exact science ... and after I thought

about it, math isn't either -- Stephen Hawkings just got through

changed his ..... errr, blah blah blah of the universe theory....;-)

 

There are pressures that families bear from the outside when it comes

to things like attention deficit disorder -- from schools, etc. Too

many just go " OK, give my kid a pill " before making sure that is the

best course for them. However, that said -- there is proof that for

some that IS the best course for them -- lives have been changed

remarkably by the different drugs that otherwise would not have been.

 

The same can be said for depression, schizophrenia, bipolar. Diet

can help some, but not all. And for those it can help, thank heavens.

 

Yes, I agree -- people are too quick to put their young children on

anti-depressants. It's sad that not everyone will do their homework

and totally puts their welfare into a doctor that probably has a

patient overload any way.

 

Now, lastly -- what really bothered me about the article??? It was

an ad -- towards the end he hawked some supplements ... that should

make any one skeptical (and I wholly believe in being skeptical).

 

Lastly, at the very last minute -- he dropped in a comment on how

9/11 was an inside job. Wherever one's opinion falls on that (and I

simply will not be goaded into another conversation on that subject),

one has to wonder what in the heck that has to do with anything.

 

Those last two things made the whole article lose credibility for me,

except for the things that were, alas, common sense.

 

Dede