Treating Mental/Emotional Diseases: Reframing Our Patients' Responses in the Questioning Process
By Bob Flaws, LAc, FNAAOM (USA), FRCHM (UK)
The following is an excerpt from Chinese Medical Psychiatry, written by Bob Flaws and James Lake, MD.
One of the things we as practitioners of Chinese medicine offer our patients is a different view and explanation of their complaints.
This difference may be even more pronounced in the field of psychoemotional disease. According to Norman Kraft, "Many (of our) patients have already been through the wringer of psychiatry and psychology, and are often experts at their own diagnosis. When we approach them with a new viewpoint, they are thrown out of their accustomed viewing of their situation."1
Kraft sees this as a good thing in that it gives us an advantage other Western caregivers may lack. The Chinese medical explanation of mental/emotional complaints is based on a unified body/mind, and it uses a number of words and concepts foreign to most Western patients such as qi; yin and yang; vacuity; and repletion. While these Chinese words and ideas may seem exotic and unusual at first, they are nevertheless based on a very down to earth, human - and humane - vision of the world. The Chinese medical description of disease causes and mechanisms uses metaphors taken from the everyday natural world. We talk of heat and cold; dampness and dryness; wind and fire; free flow and blockage; and normal flow and counterflow. These everyday explanations provide a sense of comprehensibility and manageability which are very empowering to our patients. As Kraft says, "This refocusing gives our patient the ability to see their issues in a new and in a usually much less threatening and engaging way."2 Therefore, it is important that all practitioners of Chinese medicine be able to explain these concepts in metaphors and images that are easily understandable to our patients. It is also important to explain the fact that the Chinese medical spleen or liver are not the same as the Western biological entities of the same English name. Otherwise, the patient may think they have a disease they do not.
Not only can this reframing process empower our patients in ways biomedical models may not, but the patient is much more likely to understand the aims and goals of the treatment. Compliance with all parts of the treatment will increase dramatically when the patient is inspired by the methods and excited about the goals.3
Therefore, it is extremely important to explain each patient's pattern discrimination, what it does and does not mean, as well as what the patient can do about it. Failure to adequately make such explanations available to the patient is not only potentially legally actionable, it misses a great opportunity to make use of one of Chinese medicine's most powerful attributes: its ability to provide a holistic, natural and everyday sense of how the patient is and how they could be. As Kraft eloquently puts it, "In explaining the word qi, another whole vista of the patient's life is opened."4
Kraft N. Flowering of the Heart, p. 3.
Ibid, p. 7.
Ibid, p. 4.
Ibid, p. 4.
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