The healthy shen, whether animal, plant or human, chooses behavior that successfully defends and promotes the self. The healthy shen loves the self. This loving relationship (and all loving relationships) is based on trust and the healthy shen trusts the self. That self-trust is the result of habitually paying attention to instinct.
Instinct is interior information that the pre-natal jing (genetic code) sends to the shen. This information is essentially composed of feelings, both physical and emotional. These natural feelings suggest behavior that satisfies natural needs. Human instinct supplies information that advises the shen on the following activities:
- When to eat, what to eat and how much to eat.
- When to drink, what to drink and how much to drink.
- When to defecate and when to urinate.
- When to be around other people and when to be alone.
- When to engage in sex and when to refrain from sexual activity.
- When to sleep, when to rest, when to arise from sleep and when to exercise.
- Whether to apply heat or cold to an area of the body.
- When and how much to feel mad, glad, sad and scared and all their shades and nuances.
- When to withdraw from a situation that causes pain.
Intellect Modifying Instinct
The natural purpose of mind/intellect, which relies on its own tools - memory and abstract thinking - is to modify instinct to achieve appropriate behavior. Intellect is not designed to substitute for instinct. While the American mind is often confused by advertising and techno-babble, instinct is never confused.
Following are three examples of the successful modification of instinct by intellect:
- Sleepiness: Here and now might or might not be the best time and place to sleep. I can sleep in a few hours when I get home.
- Fear: Fleeing or fighting are my choices here. Since fleeing in this particular instance offers a better chance of security than fighting, I shall swiftly exit.
- Hunger: Eating at my work station is not appropriate. But I can eat an apple at the break and then wait until dinner time to eat a meal.
The information from feelings always comes first and must be honored, as it is by all animal species. When feelings and instinct are ignored or suppressed with abstract information and intellect, as is so commonplace in technology-and-advertising-oriented American culture, the foundation for health is built on shifting sands, and the following psychic injuries occur:
- Self-trust is undermined, replaced by trust in external authority.
- Self-esteem is eroded.
- Self-healing is sabotaged.
By consulting instinct first, the foundation for healing is built on the bed-rock of self-trust. Animals, especially those living in the wild and left to their own devices, never question their own self-guiding and self-healing abilities. As a consequence, they do not suffer from low self-esteem, and their own choices do not lead to actions that sabotage the self. For example, in experiments where laboratory mice that are pressured to fatten up and then are given round-the-clock access to food but allowed to resume their normal eating patterns on their own initiative, these animals will naturally and automatically back off the calories. They swiftly lose excess body fat, and soon become as lean as they were designed to be by their genetic natures.
For Americans to stop sabotaging themselves with inappropriate choices, they must first learn to trust themselves, which means they must learn to consult and trust their feelings and instincts. Consequently, all health guidance that we give our patients should be aimed at connecting them with their own feelings and instincts. Whenever we offer advice, it should be immediately followed by the suggestion, ". . .and see how it feels." "Take this herbal formula and ask your body how it's working." "Rotate this list of foods into your diet and see how they feel." "Do this exercise and ask your body if it is right for you."
Instinct and the American Syndrome
The American habits of worrying, hurrying and overeating create the epidemic of liver qi stagnation, heart heat and spleen damp, respectively - what I call the American Syndrome. Worrying, hurrying and overeating violate our human instincts. People and animals who are true to themselves and their feelings do not worry, hurry or overeat. Reconnecting Americans with their genetically-inherited natures is the essence of effective health counseling. Let's take a look at how instinct retraining can eliminate the American Syndrome.
Liver Qi Stagnation and Chronic Fear
Whether it's called worry, anxiety, guilt, apprehension or angst, it revolves around fear of the future or past. The future and past are abstract thoughts that don't change or even exist. Obsessing about them is the essence of liver qi stagnation. This mental stagnation leads to muscular tightness, a chronic clenching of skeletal muscles and/or any organ in the body. The physical pain as well as the mental pain that result are both messages from the mind/body telling us to stop what we are doing. Pain avoidance is a very basic instinct found in all living creatures.
Stagnation also contributes to chronic excess heat conditions. Ball your hand into a very tight fist and hold it there for 30 seconds. You will notice a heat sensation with redness developing in the palm. As qi strikes a barrier, it keeps pushing and battering, trying to get through. This frenetic activity creates friction and then heat. Our task is to increase patient mindfulness 24 hours a day, so that patients can learn to prevent and stop physical/mental clenching. We teach the usage of deep breathing techniques, exercise, rest, getting plenty of sleep, the application of Taoist philosophy and the conscious decision to stop obsessing. The most effective health counselors are those who have gone down these roads before – those of us who have learned how to turn off the "worry switch."
Heart Heat and Scurrying as a Way of Life
The fire element, the heart and the shen that lives in the heart are most susceptible to excessive heat patterns. Heat is the result of friction. Friction is produced by movement. Too much movement creates too much heat, a universal feature of American life. Because the heart is constantly moving, it puts out a welcoming mat for chronic excessive heat.
Most Americans ignore their hard wiring that tells them to slow down, play, rest and sleep. "Keeping busy," depriving themselves of sleep and rest, multitasking and doing everything fast – like driving fast, thinking fast, talking fast, walking fast, working fast, i.e. "scurrying" – all are seen as virtues through the distorted lens of U.S. culture. This behavior pattern is responsible for the tremendous and unprecedented rise of inflammatory disorders such as autoimmune diseases, agitated shen disorders, insomnia and anything that has "itis" attached as a suffix.
Even the commonly encountered contradiction of red tongue with cold hands and feet is characteristic of chronic excess heat. Like a fire storm, heart heat can cause turbulence, confusing and the scattering of qi at the shoulders and hips that guides yang warmth out to the extremities. Heart heat can also confuse the qi on its way to the head, causing pseudo-blood-deficiency symptoms like dizziness and visual weakness. Our task is to increase patients' awareness and trust of instincts that tell us to stay in bed (or get to bed earlier), take plenty of short rest breaks to relieve the heat, slow down and enjoy the moment, reserve 12 hours a day for non-productive activities and concentrate on one task at a time.
Spleen Damp and Daily Abdominal Bloating
In order to control the stagnation and heat generated by the American Syndrome, Americans self-medicate to their detriment. They use TV, computers, prescribed and illicit drugs and alcohol, but by far their favorite form of sedation is food. Giving themselves permission to take a "food break," ("You have to eat to keep up your strength" and other intellectual justifications for eating), they are temporarily able to cool the heat and relax the stagnation. Enlarged fat cells – excess yin – calm this excess yang by secreting large amounts of estrogen (estriol), a powerful sedative. In addition, food – a very yin substance – sits on top on yang heat and pushes it back down.
One third of Americans are obese and another third are officially overweight. This excess yin – damp - is the easiest and most applauded way they know to control the stagnation and heat that are common features of American life. But there is a much better way, one that does not cause more disease and that actually improves human life overall. And that way is to listen to and trust the body/mind's own instincts, including the eating instincts.
The first eating instinct is the one that tells us whether to eat. It manifests as the hunger feeling. Hunger is only one thing – an empty feeling in the upper abdomen that motivates and empowers us and animals to work! Waiting for hunger and then making friends with it when it does show up is the only natural and permanent way to fat loss. Currently in America, hunger is never defined but is considered dangerous, even deadly, and something to be prevented at all costs. Ironically, fat Americans and those who graze all day never feel hunger and are not capable of feeling hunger, since hunger is the body's message that the fuel tank is nearing empty.
The second most important eating instinct is the one that tells us how much to eat. When the body sends us a message of comfort in the upper abdomen while simultaneously the deliciousness of food starts to decline, it's time to stop eating. Continuing past this level adds fat (excess calories) to the body, and causes spleen damp, abdominal bloating and constipation. These conditions are clear violations of this instinct and are endemic to American life.
The third eating instinct is the least important for Americans and only occurs in the presence of hunger. It is the food choice instinct and it tells us what to eat. In a rich country like ours, in which the general population doesn't know starvation or malnutrition diseases like beriberi, scurvy, kwashiorkor, marasmus or pellagra, or children with pencil-thin extremities and swollen bellies, what to eat is of minimal or no importance.
However, it is this information that American advertising has completely intellectualized in the minds of most Americans, shouting down the other two instincts – in effect silencing them. Most patients come to us in a confused state, desperately searching for someone to tell them what to eat and what not to eat. Our task is to disabuse them of these harmful and obsessive thoughts, and reconnect them with their eating instincts, the hard wired information they were born with. Teaching people to wait for hunger and to stop eating when comfortable, while at the same time refusing to pander to prevailing "wisdom" regarding "good" foods and "bad" foods – this is what will set us apart from all other health practitioners and build our reputations as true and effective healers.
Clearly, the substitution of intellect for instinct is the fundamental cause of the American Syndrome of liver qi stagnation, heart heat and spleen damp. The repositioning of instinct before intellect will eventually result in the diminution and eradication of the American Syndrome.
E. Douglas Kihn a doctor of Oriental medicine, is the author of "Chinese Medicine for the Modern World." He resides in West Los Angeles and can be reached at