Acupuncture and Emotion by Charles Yarborough, L. Ac.

Several decades ago, the concept of personality as a predictive

factor in disease was formally introduced to the West.
Appreciation of the Type-A personality, with its hostility, its
hurried mindset and polyphasic thinking, drew widespread
attention to emotion as a factor in the genesis of disease.
Subsequently, another illness-prone personality type-Type D-
was recognized by its characteristic suppressing of negative
emotions. Western clinical researchers in recent years have
scrutinized the relationship between emotion and illness. Can
negative thinking, they ask, make a person sick? More recently
they have added, in counterpoint: can positive thinking
(generated by prayer and imagery) help a person heal? While
these questions may pose a fairly binary approach to the
matter, binary it must be, since Western clinical studies cannot
be conducted on poetic or allegorical explanations of
mind/matter such as we find in Traditional Chinese Medicine.
For authentic practitioners of Oriental Medicine, however, the
interplay of organs/emotions/spirit is inescapable.
An ancient text, the “Huang Ti Nei Ching”, compares the
function and position of internal organs to hierarchies found in
an empire. It tells us: “The heart is like the minister of the
monarch who excels through insight and understanding; the
lungs are the symbol of the interpretation and conduct of the
official jurisdiction and regulation; the liver has the functions of
a military leader who excels in his strategic planning; the gall
bladder… excels through his decisions and judgment; the
middle of the thorax is like the official of the center who guides
the subjects in their joys and pleasures…the kidneys are like
the officials who do energetic work and they excel through their
abilities….” (1)
In her translation of the “Nei Ching”, Ilza Veith explains that
the heart, the spleen, the lungs, liver and kidneys “determine
the functions of all the other parts of the body, including the
bowels, and also of the spiritual resources and emotions”(2).
Logically then, we should consider involvement of these five
organs when the issue of emotional problems is presented. Has
the comparative weakness of certain organs, we might ask,
exposed a patient to illness or to prolonged recovery? Could the
illness cause depletion of specific organs, creating a self-
defeating cycle? While the practitioner must be careful to leave
psychology to the psychologists, he or she will nevertheless
recognize patterns of behavior/illness and opportunities for
therapy which have been described in ancient texts.
Emotional Concepts
What is the ancient concept of emotions and how does it relate
to modern Western clinical practice? In the book Emotions in
Asian Thought, Chad Hansen contends the traditional Chinese
concept of mind and action does not center on “a
mental/intellectual world populated by mental/intellectual
objects set off against an external world of physical objects or
matter.” Nor does this concept contain the Indo-European
“distinction between cognitive and affective states. A single
faculty/organ, the xin (heart-mind), guides action rather than
separate faculties of heart and mind”(3).
Giovanni Maciocia, in his textbook The Fundamentals of
Acupuncture, widens this premise for the purpose of clinical
practice. Maciocia notes the tradition of Five Emotions: anger,
joy, sorrow, fear and rumination, as well as others, and
explains their significance to the practitioner. “The body-mind is
not a pyramid, but a circle of interaction between the Internal
Organs and their emotional aspects. Whereas Western Medicine
tends to consider the influence of emotions on the organs as
having a secondary or excitatory role rather than being a
primary causative factor of disease, Chinese Medicine sees the
emotions as an integral and inseparable part of the sphere of
action of the Internal Organs…. Since the body and mind form
an integrated inseparable unit, the emotions can not only cause
a disharmony, but they can also be caused by it”(4). Anger,
according to tradition, affects the liver; rumination taxes the
spleen; sorrow depletes the lungs; excessive joy affects the
heart, and fear affects the kidneys.
Fear And Panic: A Case Study

“Extreme fear,” says the “Huang Ti Nei Ching”, “is injurious to

the kidneys.” An example of long felt fear and its taxing effects
on kidneys was presented to me in a phone call last year. “Can
you help me?” came a man’s faint voice. “I’m agoraphobic; do
you know what that means? Have you ever treated this
condition?” I told him I hadn’t treated it but knew that it was a
debilitating anxiety disorder marked by fear of public places
and situations that are associated with panic attacks. “That’s
it,” he said. “I haven’t been away from my house in six years.
Only, I get attacks even when I’m at home. Sometimes my
heart starts beating like crazy, like I’m going to have a heart
attack or go nuts.”
The man’s symptoms conformed to the DSM (Diagnostic and
Statistical Manual) requirements for panic disorder. These
requirements are four episodes in a four-week period, featuring
four of these symptoms: pounding heart, tightness in the chest,
shortness of breath, feeling of choking, tingling, faintness,
shakiness, trembling, fear of losing control, hot flashes, a sense
of unreality and a fear of going insane or dying. To compound
these troubles, comments Jerilyn Ross in her book, Triumph
Over Fear, while “the fear during an attack is real, raw,
crushing, and overwhelming…physicians tend to write off
patients as neurotic or hypochondriacal”(5). This may be a
monumental oversight if one considers that 2.4 million
Americans suffer from panic disorder in any given year
(National Institute of Mental Health).
The man on the phone drew a deep breath. “It means you’d
have to come to my house,” he said, “since I can’t go out.” I
drove to the upscale section of Los Angeles where he lived. His
house, a sprawling mass of glass walls and sharply angled
stucco slabs, was a specimen of the atomic era. And like the
atomic era, it was a vision gone bad. Currently, the expansive
yard was overrun with weeds and the many windows were
covered by torn, yellowed curtains and sagging, rusty blinds.
Kicking aside an empty mayonnaise jar, I walked a wide
limestone path to his door.
The man who answered my knock was six feet tall, fifty years
old and was clearly a frail version of his former self. Noticeable
also were deep brown circles under his eyes (kidney area of the
face). While he retained a full head of hair, it was
unmanageably dry and had been corralled into a ponytail.
“Come in,” he said, waving me into a musty hall. He handed
me his dry, bony hand to shake. His name was Frank and for
many years he had been a successful stunt driver for television.
The “King of Car Chases”, they had called him.
Unfortunately, he had experienced three mishaps in the course
of six months, the last of which landed him in a full body cast.
Upon recovery from his most recent accident, he found himself
unable to drive to work; panic gripped him when he got behind
the wheel. He had tried therapy without success (probably a
poor choice of therapist), had spent a fortune on therapeutic
audiotapes and books and, because of his refusal to take
medication, was considered “a faker” by his family.
Based on query and observation, I formed a diagnosis and
treatment plan. While many agoraphobics cannot locate the
specific cause of their disease (it may be the
accumulation/magnification of perceived dangers), Frank’s
crippling fear seemed traceable to his continued mishaps and
their potential future recurrence. “Kidney Qi energies,” writes
Leon Hammer, M.D., in Dragon Rises, Red Bird Flies, “help us
to anchor ourselves in the gestalt of the ‘here and now’…”(6).
Overall depletion of the kidneys was manifested in a deep,
weak kidney pulse (the proximal position on the radial artery),
lower back pains, tinnitis, palpitations, dizziness and dark
pouches under his eyes. Chronic fear had taxed Frank’s kidney
Yin, as his dry hair, skin and acquired boniness attested. He
was the shriveled relic of a once-daring stunt driver. His
depleted kidneys failed, as the Nei Jing says, “to do energetic
work and excel through…ability.” Frank’s abilities were being
wasted, although I wasn’t certain the world would be improved
by more car chases. Nevertheless, I decided on a therapeutic
principle and a “points strategy” as outlined in The Treatment
of Disease in TCM.(7) I determined to supplement the kidneys,
fill the essence, and fortify the will. My formula would have
been a modified “Liu Wei Di Huang Wan”, except that Frank
was in terror of herbally-induced panic. Herbs were not an
option. Predictably, Frank was also in fear of needles. I
therefore gave him a kidney-enhancing mix of shiatsu and
tuina, later convincing him to accept but four needles (L14 and
LIV3 bilaterally) to “open the gates” and allow Qi to flow.
When I returned to the office, the phone was ringing. Frank
was in a panic. The unleashing of the Qi prompted by my
nominal needling had caused him alarm, triggering a panic
attack. I reassured him and talked him into a calm state of
mind, agreeing to return the following day. In subsequent
twice-weekly visits, I gave him nothing but acupressure and
tuina, always with the purpose of stoking kidney fire. Over the
course of several months, he reported gradual improvement
and began venturing away from home, driving to the mall with
family and attending church. While there are occasional
setbacks, his overall outlook is favorable. An increasingly
confident and robust Frank is now searching for a qualified
therapist… and, at my urging, a desk job.
Anger: A Case Study
“Sickness of the liver,” the Nei Jing tells us, “causes…people…
to have fits of anger.” Anger causes Qi-and tempers-to rise.
Maciocia reminds us that anger can be considered to include
irritability, frustration, rage, indignation, animosity or
bitterness. Anger, when expressed appropriately, may not
cause harm; when chronic or suppressed, it may become
pathogenic. A study published in a recent issue of The Lancet
found that the “Type-D personality was a significant predictor
of long-term mortality in patients with established CHD [chronic
heart disease]…. Personality traits should be taken into account
in the association between emotional distress and mortality in
CHD”(8). The American Journal of Cardiology concurs: “Anger
is the effective state most commonly associated with
myocardial ischemia and life-threatening arrhythmias. The
scope of the problem is sizable-at least 36,000…heart attacks
are precipitated annually in the United States by anger”(9).
When anger causes Qi to rise, symptoms are naturally
expressed in the upper part of the body. A patient will often
exhibit dizziness, a flushed face, tinnitus and headaches
(frequently parietal). His or her tongue may be red due to liver
fire, the result of prolonged liver Qi “stagnation” or
“repression.” Additionally, rebellious liver Qi may flow sideways,
invading the stomach and its paired organ, the spleen. This will
result in diarrhea and indigestion.
Liver Qi oppression and its consequences were embodied in a
diminutive lady named Mrs. LeBeau. While Mrs. LeBeau may
have been petite, her repressed fury was not. She solicited my
help with resolving increasingly frequent parietal headaches
and indigestion. It took little effort to discover the cause of her
illness.
Removing her suede pearl-white gloves and placing them on
my desk, Mrs. LeBeau marched to my treatment table and lay
down. She then said hello and held out her hand impatiently.
Not knowing if she expected me to shake it or kiss it, I took her
pulse instead. She was, by her account, “fifty-something,” yet I
noticed she had fewer wrinkles than the Chanel pant suit she
had poured herself into. Her pulse was “wiry” in the liver
position, suggesting pain or repressed anger. Mrs. LeBeau
spoke incessantly and admiringly of her husband, a highly
successful corporate motivational speaker. She was, she said,
the luckiest woman in the world. Her unstoppable eulogizing of
Mr. LeBeau, however, was clearly practiced, as if she had
delivered the monologue many times previously. It was only as
she relaxed that her pace slowed and, eventually, a frown
made her lips droop. In a sudden burst of tears she revealed
her husband abused her, and she did not love him anymore.
Leaving him was a moral impossibility since he had recently
been diagnosed with cancer. “And besides,” she sobbed, “it
simply isn’t done! Are you or are you not going to offer me a
tissue?” It was interesting to note that Mrs. LeBeau’s cosmetic
surgeon had removed all facial evidence of intense liver Qi,
lines which extend vertically from the inward tips of the
eyebrows. Resigned she was to a duplicitous life, attending
social functions and televised events wearing a smile that was
not her own. Meanwhile, her headaches had become frequent
and nearly intolerable. Food, she complained, caused her to
bloat and belch and she experienced a continual bitter taste.
While there was little I could do to improve the circumstances
of her life, I was able to address, on an energetic level, Mrs.
LeBeau’s liver symptoms. Her long-repressed anger forced
rebellious liver Qi to flow upward, causing headaches and bitter
taste, and to flow “sideways,” toward the stomach/ spleen. The
result was indigestion and bloating. If left unchecked,
suppressed liver Qi could turn into liver fire, with its attendant
violent, unpredictable behavior. My treatment plan was to
soften the liver and descend rebellious liver Qi. Modified Xiao
Yao was the herbal remedy.
Statistical Proof
My concern for Mrs. LeBeau was further fueled by statistics
recently published in Nursing Research. In an article, “Women’s
Anger: Relationship of Suppression to Blood Pressure,” we find
a 12-year Michigan study of middle-aged men and women
which “showed that suppressed anger significantly interacted
with elevated blood pressure to produce the highest
mortality”(10). It appeared that people with elevated blood
pressure who scored higher on anger suppression were five
times as likely to die than hypertensive people who expressed
it. On reading this, I directed Mrs. LeBeau to a qualified
therapist whom she now sees regularly in addition to receiving
her acupuncture treatments.
As these case studies show, the management of emotion-
associated illness may be slow, requiring great patience and the
scrupulous application of ancient Oriental principles to modern
dilemmas. Nevertheless, such concepts of emotion, illness, and
the expression of character are as pertinent today as they were
more than a thousand years ago when Laotse wrote:
“Those who are disturbed by their senses and minds cannot
preserve their own character. How much less can they follow
the Tao!” (11)