Medical Acupuncture in the Treatment of Chronic Stress-Related Illness
By Martha M. Grout
Stress related illness can be defined as any illness whose root cause can be attributed to chronic excessive release of stress-related neurotransmitters. Such illness can include common problems such as anxiety, depression, irritability, insomnia, hypertension, stroke, myocardial infarction, irritable bowel syndrome, as well as less clearly medically defined problems such as chronic fatigue syndrome, fibromyalgia, and even auto-immune diseases.
The neurotransmitters and neuropeptides are the biochemical messengers through which information is transmitted or translated from the mind to the body and back.1
Neurotransmitters include not only the commonly known stress molecules (epinephrine, norepinephrine, dopamine and corticosteroids), but also a host of others neuropeptides, short chains of amino acids present in both brain and body cells, with specific receptors on the cell membranes. Recent research shows that almost all communication between different parts of the body occurs by means of this psychosomatic network, a host of neurotransmitters, immunotransmitters, hormones and other chemical substances found in many different tissues in the body. Dr. Candace Pert calls these neuropeptides "molecules of emotion."2 We have neuropeptide receptors all over our bodies, including the gastrointestinal tract; the white blood cells; the kidneys; and the pancreas, giving scientific validation to the ancient Chinese understanding that we feel emotions in all of our elemental organs, although the emperor organ, the heart, is the only one that consciously experiences the emotions. According to Dr. Ernest Rossi, a noted hypnotherapist and student of Milton Erickson, "The autonomic, endocrine, immune and neuropeptide systems are communication channels whereby mind may activate genes and the internal cellular machinery."3 Cholecystokinins in the GI tract, immunotransmitters in nerve cells and white blood cells, and insulin in the pancreas (the middle burner, the solar plexus chakra, the source of our power in relationships) all have receptor sites in the brain.
When we experience a particularly trying event, the memory is encoded by means of unique combinations of these chemical transmitters. If the memory is too painful for our conscious minds to deal with, it may be stored (and effectively buried) in particular places in our bodies. As long as the memory is still encoded in the body, it may try to bring itself to our attention by causing pain, dysfunction or imbalance in that place where it was stored.4 Consider, for instance, the patient with chronic neck and back pain, unresponsive to standard therapies and only partially responsive even to acupuncture. Needling a particular place on the neck brought to the surface memories of a five-year old being grabbed by the neck by his father, with the attendant feelings of "I didn't do anything! I am small and powerless! It's not fair." This patient had encoded that memory in the part of the body related to the upper burner, the lungs, whose associated emotion is grief, and which is concerned with structure and rules, justice and duty; and the heart, where that emotion is experienced. Once the memory was released and the father was forgiven, the physical pain was completely relieved.
How Can Acupuncture Help?
First, we can diagnose the medical illness, imbalance or problem that brings the patient to us. We are obligated to use our Western diagnostic skills and modalities, to determine whether we are dealing with a functional illness; with something that is surgically correctable; or even a life-threatening condition like pneumonia, sepsis, diabetic ketoacidosis or cancer.
Second, we can diagnose the energetic imbalance, using the system to which we best relate. We may use five-element diagnosis,5 French energetics6 or traditional Chinese medicine syndromes.7 In the end, if we diagnose correctly, we will all come to the same conclusions about the imbalance, although our plans of treatment may be different, depending on which system we are using.
Third, we treat the whole person: body, emotions, mind and spirit.
If the disease or problem exists primarily on the emotional level, then our acupuncture treatment is directed at this emotional level, as well as the physical level. I find that the outer bladder line points are most helpful in this regard.8 I use BL42 (pohu) as well as the lung shu point BL13 (feishu) for patients with Valley fever or asthma, in which the root cause is likely to be an issue of enormous grief. Similarly, I use BL47 (hunman) and the liver shu point BL18 (ganshu) for patients with hepatitis, where the cause is rooted in emotions of anger or irritability. The gallbladder shu point BL19 (danshu) is combined with BL48 (yanggang) for patients with gallstones or cholecystitis, where is root issue is repressed anger and lack of courage to move on.
I also activate the fu organs themselves for their metaphorical functions. Issues of irritability may express themselves in the stomach as ulcers or gastritis, with the emotional issue revolving around "What is there that you cannot stomach?"9 The stomach mu point CV12 (zhongwan) and the shu point BL21 (weishu) are most helpful for treatment of these issues. I frequently use the small intestine mu point CV4 (guanyuan) or the shu point BL27 (xiaochangshu) for people who are unable to clarify the issue, "What is there that you cannot sort out?" and whose manifestations tend to be bloating or irritable bowel syndrome. The large intestine mu point, ST25 (tianshu) and shu point BL25 (dachangshu) are very useful for those patients who are unable to let go of that which no longer serves them. They tend to have issues of forgiveness, and manifestations of chronic constipation or colitis.
If the problem lies in the patient's fundamental mindset ("I am not worthy," "I am ugly," "I do not deserve the good things in life") as often occurs in cases of childhood neglect or abuse, it is important to work with the mindset as well. Abuse may not necessarily mean gross neglect; it may be as simple as Mom being preoccupied with a new baby, or Dad being chronically disappointed because we got Bs rather than As in school. The cerebral circulation pathways10 are particularly helpful for such core "mindset" issues of worthiness. These pathways are based on a combination of French energetics, anatomy and molecular biology.
The yin channels of the leg - tai yin spleen, shao yin kidney and jue yin liver - originate from cephalad points on the three leg yin meridians, and continue their influence deep into the brain, connecting eventually with the yang channels of the leg in the head, yang ming stomach, shao yang gall bladder and tai yang bladder, which run superficially over the head and face. The cerebral circulation pathways, arising from the cephalad points, influence the sensory organs associated with the three yin meridians, as well as the associated emotional states.
The kidney cerebral circulation is activated from KI27 and is focused on SI19 (tinggong) for the ear, or on BL10 (tianzhu) for the posterior pituitary gland across which the channel travels. The pituitary gland is the great controller of our endocrine organs, secreting vasopressin or anti-diuretic hormone, which regulates water balance, blood flow and urine flow. This pathway is useful in any ear problem as well as any endocrine problem, and is particularly useful for those patients whose primary issue is that of fear of change; fear of relationships; or fear of living in general.
The liver cerebral circulation is activated from LR14 (qimen), and is focused on GB1 (tongziliao) for the eye or on GB20 (fengchi) for the anterior pituitary gland. The anterior pituitary gland secretes luteinizing hormone, which is used in lactation; follicle stimulating hormone, which regulates the ovaries, and ACTH (adrenocorticotropic hormone), the precursor of beta endorphins and enkephalins.11 Stress-like behavior, memory, attentiveness and learning are all mediated through the adrenal glands. This pathway is especially useful in people with attention deficit hyperactivity disorder, who clearly exhibit characteristics of liver wind (darting about and being unable to focus clearly). This pathway is also useful for our hypertensive chronically irritable patients, as well as those with refractory eye problems such as glaucoma and macular degeneration. This pathway is particularly useful in the treatment of those patients who are crippled by their irritability and anger, or who spin their wheels and never move forward.
The spleen cerebral circulation is activated by the highest point on the spleen meridian, SP20 (zhourong). It ascends through the pharynx to the maxillary sinuses and olfactory bulb. The focusing point is ST1 (chengqi) for the sinuses; BL1 (jingming) for the nose; and ST9 (renying) for the throat. The extra meridian point GV24.5 (yintang) can also be used for both olfactory and sinus problems. This may be very useful in treating chronic sinusitis that has been unresponsive to other less aggressive treatments. Since the spleen is charged with both logical thinking and intuitive thinking (through the nose), this pathway is also useful in treating patients with confusion and memory dysfunction, and those who have suppressed their intuition, who live "all in their heads" and are excessively logical. It is especially useful for those who get gridlock or stagnation on any level, those who have obsessive-compulsive disorder, and chronic worriers.
Medical acupuncture is extremely useful in the treatment of many chronic stress related illnesses, not only because of its effectiveness in treatment of the physical body, but also (and perhaps more importantly) because of its ability to penetrate the layers of defense and coping mechanisms which our patients exhibit. Once the defenses are penetrated, the patients have the opportunity of choosing to deal differently with their issues. Since, as we have demonstrated, the mind and the body are one inextricably connected entity which uses the emotions and their attendant neuropeptides as the vehicle for communication, it is clear that by treating the physical body, we can penetrate deeply into the emotions. By releasing the emotions, we can help our patients change their response to stress, and thereby enable them to heal that physical entity known as the body-mind.
Pert C, Dreher H, Ruff M. The psychosomatic network: foundations of mind-body medicine. Alternative Therapies July 1998;4(4):30-41.
Pert C. Molecules of Emotion. Simon & Schuster, 1999; ISBN: 0684846349.
Rossi E. The Psychobiology of Mind-Body Healing. New York: WW Norton, 1993, p. 189.
Greenwood, MT. Individuation, splits in Western consciousness from an acupuncture perspective. Medical Acupuncture Fall/Winter 2000;11(2):11-16.
Beinfield H, Korngold E. Between Heaven and Earth: A Guide to Chinese Medicine. New York: Ballantine Books, 1991.
Helms J. Acupuncture Energetics: A Clinical Approach for Physicians. Berkeley, CA: Medical Acupuncture Publishers, 1995.
Maciocia G. The Foundations of Chinese Medicine. New York: Churchill Livingstone, 1989.
Deadman P, Al-Khafaji M. A Manual of Acupuncture. Ann Arbor, MI: Journal of Chinese Medicine Publications, 1998.
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Helms J. Acupuncture Energetics: A Clinical Approach for Physicians. Berkeley, CA: Medical Acupuncture Publishers, 1995, pp. 432-440.
Rossi E. The Psychobiology of Mind-Body Healing. New York: WW Norton, 1993, p. 188.
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