When the heart is at ease, the body is healthy.
—Chinese Proverb
CHAPTER 8
Heartbreaker
Have you ever had your heart broken? Do you remember how you felt? Did you feel like you would never recover? Sometimes the aftermath can be so bad that friends and family think about doing an intervention, or you feel like having yourself committed. The effects of feeling like your heart has been ripped to shreds can include anxiety; the inability to eat, sleep, or think; chest pain; fatigue; depression; and weight loss or gain.
Have you felt all of the above and maybe much more? Heartache can come from romantic love, a loss of a friend or companion, or a shock such as being hurt or betrayed by someone you love.
It is said that you can die from a broken heart. You’ve probably heard the stories of an elderly couple who had been together for decades dying within months of each other. Well, in TCM this makes complete sense. When you’ve had a big shock or had your heart broken, it can deplete your heart’s qi to the point where it actually stops beating. A great emotional shock to the heart, usually from the death of a long-term spouse, drastically depletes the heart of its qi. Without enough qi, the heart, or any organ, for that matter, can’t function anymore.
In Western terms, the physical pain we’ve all experienced can come from a rush of adrenaline or other hormones, leading to decreased blood flow to the heart or stunning the heart into not pumping properly. This lack of blood leads to chest pain. That’s why a breakup can physically hurt so damn much. It’s not your imagination. Physiologically there’s something happening.
The Fire element is associated with the heart and small intestines and opens to the tongue. This element is also associated with summer. Fire is about passion and being dynamic. When the Fire element is strong, you can easily experience joy, laughter, love, and an eagerness to live life. You can share love unconditionally and easily with a balanced Fire element. You can effortlessly share kindness and compassion with those around you, even if you don’t really like them. If you have a healthy Fire element, even having your heart broken by someone you love won’t hurt as much or last as long. You intuitively know with whom it is safe to be vulnerable.
When Fire is weak you might be emotionally sensitive or cold, or very insecure when it comes to love and love relationships. You can be passionless, easily hurt, or even codependent. A fragile Fire element can also result in the constant fear of rejection. Someone who manically talks, laughs inappropriately, and is always telling jokes has a compromised Fire element.
Opening to or affecting the tongue, as you learned earlier, means that if you’re experiencing a heart imbalance, you may have issues with your speech. This includes muteness, lisps, a “cat got your tongue” feeling, and stuttering. If you have experienced true heartache, you can probably remember a few instances when you felt like you couldn’t get your words out.
As the chart below shows, there is some overlap in functions when comparing Western and Chinese theory. But the heart has a whole host of functions in TCM that Westerners don’t normally connect to it.
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Functions of the Heart |
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Western Medicine |
TCM |
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Regulates and promotes circulation of oxygenated blood throughout the body |
Regulates blood flow |
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Removes waste |
Regulates sleep and houses your mind/soul |
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Controls sweat |
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Sends heat to bladder and uterus |
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Stimulates small intestine function |
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The heart is considered the king of all the organs in TCM. It is necessary to keep the heart healthy and happy to guarantee the health of the rest of the body. Without maintaining its optimal function, a person cannot live a full life mentally, emotionally, spiritually, or physically. The heart regulates blood flow throughout the body, into every cell, regulates the amount and quality of sleep, houses your soul/mind, provides warmth to the spleen, stimulates the function of separation in the small intestines, and sends heat to the bladder so that it can excrete fluids (make you pee). Pay attention to your urination if you experience insomnia. Burning urination upon waking might be the result of your heart sending too much heat to the bladder or small intestine during the night. And if the heart is imbalanced, it will show up in some way on the face, perhaps a blemish, change in color, or a skin condition.
What do I mean when I say that the heart “houses the soul”? It is a Chinese belief that our soul or consciousness rests in the heart at night while we’re sleeping. That is the main reason that any issues with the heart will likely show up as insomnia and/or mental health complaints. The mind needs a safe, cozy place to go for some downtime. It needs plenty of rest to function well. Think about the last time you couldn’t sleep. How cranky were you the next day? Imagine having chronic insomnia and what that would do to your mental state.
The heart also provides warmth to the spleen to aid in digestion. It stimulates the function of separation in the small intestines. Too much heat in the heart can lead to abdominal pain, sudden loss of hearing, and burning urination. The heart also sends heat to the uterus to keep blood moving. Not enough heat can manifest as menstrual cramps or the lack of a period, or with too much heat quite the opposite: heavy bleeding.
The heart controls sweat, which is very obvious when someone having a heart attack begins to sweat profusely—usually an oily type of sweat. Unexplained spontaneous sweating can be caused if there is not enough qi in the heart.
The small intestine is the yang-paired organ to the heart. It relies on the heart’s heat to aid in metabolism. “Small intestine” is a funny name for something that averages about twenty feet long. It is actually much longer than the large intestine, which is typically about five feet long but gets its name because of its width: The small intestine is typically one-third the width of the large intestine.
As with all yang organs, there are just a few symptoms related to an imbalanced small intestine. Among them are difficulty determining right from wrong, burning urination upon waking, abdominal pain, sudden hearing loss, gas, vomiting, and either scanty or excessive urine. The small intestines can also have parasites.
The emotions associated with the small intestines are similar to the heart, with the additional ability to determine right from wrong. So small children, whose small intestines are still developing, need guidance as to what is “bad” and “good.” Dishonest people can still have healthy small intestines even if they know what they’re doing is wrong. Some of these people are called psychopaths; they do bad things but have no conscience, or they even get pleasure from harming others.
In Western medicine the small intestine absorbs nutrients and removes waste. In TCM it serves to separate the impure from the pure. It can help eliminate physical impurity—waste or toxins—but also emotional impurity. This makes it unique. For example, when someone says something negative to you, such as “I hate you,” the small intestine takes that negative message and keeps it away from the heart. The heart will then be protected from any damage. In TCM, harmful words and actions, not just harmful foods and substances, can hurt an organ. The heart is the most vulnerable, which is why the small intestines, along with the pericardium, protect it.
Susan, one of my patients featured a little later in this chapter, is the poster child for this issue. She is what is called an empath. Empaths are highly sensitive and feel everything, sometimes to an extreme. They are naturally very giving and good listeners. When empaths absorb the impact of stressful emotions, it can trigger panic attacks; depression; food, sex, and drug binges; and a plethora of physical symptoms. Susan definitely takes on other people’s pain and baggage. This is probably a contributing factor to her drug addiction.
There are several emotions associated with the heart in TCM, even more than the liver, which sort of makes sense to our Western minds, doesn’t it? The heart is where physically we feel our feelings, where we love, ache, grieve, and feel joy.
Lack of joy, excitability, anxiety, heartbreak, long-term memory loss, depression, and mental illness are all symptoms of an imbalanced heart. All of these examples can be temporary or more chronic, mild or severe in nature.
The physical signs of an imbalanced heart are mostly connected to the actual (physical) heart, and there are fewer symptoms than for any other yin organ. They include angina/chest pain, heart disease, heart attacks, epilepsy, encephalitis, irregular heartbeat, stuttering, palpitations, bitter taste in the morning, pain or temperature change along the heart channel, aphasia (inability to speak), muteness, shortness of breath when exercising, poor long-term memory, menopausal symptoms (the kidneys can also cause menopause symptoms), and arrhythmia.
Palpitations involve an irregularity of the heartbeat. They can manifest either as a rapid or slow pulse or skipped beats, which can lead to difficulty breathing. They are generally not dangerous if there is no underlying heart disease. Non-heart-related causes of palpitations include illegal drugs, certain legal drugs that stress the heart, alcohol, caffeine, nicotine, vigorous physical activity, stress, panic attacks, anxiety, low electrolyte or blood-sugar levels, dehydration, thyroid disorders, low blood pressure, anemia, and some herbal/nutritional supplements. Female hormonal changes can also lead to palpitations, particularly those that occur during pregnancy, menopause, perimenopause, or menstruation.
If you’ve ever experienced palpitations, you know they can be pretty scary and uncomfortable. Can you imagine having them every day for months?
A big chunk of symptoms related to the heart involve mental illness. These include bipolar disorder/manic depression, schizophrenia, addiction, borderline personality disorder, panic attacks, rash/impulsive behavior, laughing for no reason, attention deficit disorder (ADD) and/or attention deficit/hyperactivity disorder (ADHD), obsessive(OCD), autism, insomnia, and nightmares.
Case Studies
Since a majority of my patients come to me for mood enhancement and/or addiction, I have a plethora of case studies from which to choose for this section. Rick and Susan both had addictions and mental health problems, which is really no coincidence, because most addicts are self-medicating some type of mood disorder. This means people who have issues with depression, anxiety, or even more severe issues like schizophrenia often will reach for a drug, drink, and/or food to suppress and temporarily alleviate their emotional pain. This never fixes the problem and can lead to addiction.
Rick
When he first came in for treatment, Rick’s main health concern was heart palpitations. He’d been experiencing them for eight months, and they had been occurring daily for three months. He had every imaginable test done on his heart and thyroid, and everything came back fine. Rick also had no history of panic attacks or recent drug use (apart from caffeine), so those were also ruled out. Previously Rick had been smoking marijuana daily to reduce his stress levels at night, but he stopped once the palpitations got severe. He wanted to see if his drug use was contributing to or causing his problem, but his symptoms did not change when he quit. (Note that for some people, marijuana can cause palpitations.) Rick wasn’t taking any medications. He was a forty-two-year-old married lawyer with no children who worked sixty hours per week.
Rick had a few other medical issues, all of which he felt he could live with. But I wanted to know about them to get a complete picture of what was going on. Having all the information enables me to give the best diagnoses and treatment plans. He had constipation, gas and bloating, dry skin, low back pain, and painful, burning urination upon waking. Tests showed no infection or prostate problems that might be causing the urination issues.
Rick had nightmares regularly and experienced difficulty falling asleep nightly most of his life. His single mother was bipolar, and the result was a very unstable upbringing. Rick said he’d tried melatonin and other natural supplements without much success. He tried sleeping pills for a couple of weeks; they knocked him out, but he woke up after four hours and felt out of it the next day. This affected his work, so he stopped taking them.
From the first time we spoke, I knew Rick had some emotional issues. Even over the phone, he was very pushy about my accommodating his schedule. Rick expected me to come in after hours and on my days off for him. When I couldn’t, he felt like it was a personal affront. His demeanor with me was aggressive and he got very angry when I reminded him he needed to be on time for his appointments (he was late for every appointment). Unfortunately, I had to let him go after twelve weeks due to his erratic behavior. I learned that at age forty he had been diagnosed with borderline personality disorder, which accounted for much of his behavior.
According to the National Institutes of Health, “borderline personality disorder (BPD) is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. A person with BPD may experience intense bouts of anger, depression, and anxiety that may last only hours, or at most a day. These may be associated with episodes of impulsive aggression, self-injury, and drug or alcohol abuse.” (I am specifically citing this disorder here because few people know about it. Psychiatric professionals have tried to treat BPD with some combination of medications and therapy, with mixed results.)
Rick’s issues with scheduling may have been related to his BPD. He also mentioned the dynamics of his marriage and how unfair his wife was to him. When asked for an example of his wife’s unfairness, his answers seemed insignificant: She was unable to remember that he hated blueberries and loved Britney Spears. Small slights such as these made him feel like she didn’t really love him.
As with a majority of my patients, Rick ate a SAD diet. His standard routine included fast food, minimal water, five cups of coffee daily, no fresh fruits or vegetables, microwaved meals, cookies, and cakes. And following a pattern that has become all too common, none of his Western doctors had asked a single question about his eating habits.
Luckily, Rick was willing to try new things to get better. The palpitations scared him so much that he was starting to get desperate. He took Chinese herbs three times a day, had biweekly acupuncture, and revamped his diet. My nutritional advice started with the usual recommendations for SAD eaters: Drink more water, give up fast food and sugar, and reduce caffeine intake. For the time Rick was under my care, he was able to reduce his caffeine intake to only one cup of coffee per day. He had headaches at first and was a bit tired, but that improved after a few weeks. Within three weeks he was drinking six cups of water per day, a huge improvement for someone who previously drank at most one glass a day. Rick also cut out all refined sugar in six weeks, although he had a hard time giving up fast food and was still eating it several times per week—but he did add fruits to his breakfast and a salad every few days.
His meal plan was pretty simple. Here’s an example of what I suggested for him:
Breakfast: oatmeal with banana, tahini, and hemp milk.
Lunch: enchiladas with kidney beans, scallions, red bell pepper, garlic, brown rice, and corn tortillas.
Snacks: celery sticks and hummus.
Dinner: salad with cucumber, celery, lettuce, mushrooms, radish, and bell pepper, and a creamy tomato soup with dill. (My favorite tomato soup recipe is super easy to make! Use onion, garlic, tomato, miso broth, and cashews. You can add either basil or dill, depending on which you prefer. Puree the cashews with either water or unsweetened nut milk before adding to simmering soup. Simmer for 15 minutes, and it’s done.)
Rick saw many of his symptoms alleviated, even within a few months. I suspected caffeine, dehydration, and stress as the three main causes of his heart palpitations, and cutting back on caffeine and drinking more water helped tremendously. Rick’s low back pain was minimized as well. This was primarily due to the increase in water (he was very dehydrated) and stronger adrenals after reducing his coffee intake. He also became less aggressive (typical in borderline personality disorder patients as a result of acupuncture), but he was still too much for me to handle. I hope Rick stuck with his new, healthy lifestyle.
Recap of Rick’s Fire symptoms: palpitations, borderline personality disorder, burning urination, insomnia.
Susan
I’ve seen all kinds of mental illness cases and have heard some horrible stories over the years—starting during my internship in a psychiatric unit at a local hospital—so not much can faze me. Yes, I still feel compassion for all my patients and what they’re going through, but it’s rare that someone’s story completely shocks me anymore (I don’t know if this is a good thing or a bad thing). But Susan’s story definitely knocked me for a loop.
Susan was referred to me by one of her friends who had been my patient and had gotten relief from lifelong depression. He was hopeful I could help Susan as well. I didn’t know anything about her background, until he brought her to my office. Susan was a fifty-three-year-old recent widow with no children. Her chief complaint was daily panic attacks, which had been going on for six months. She had been hospitalized four times because her anti-anxiety medication wasn’t helping. On several occasions Susan felt like she was having a heart attack, which can be a symptom of panic attacks.
In addition to experiencing severe heartbreak related to the recent, violent death of her husband, Susan had witnessed his murder, during which she had also been threatened. Can you imagine going through that? No wonder she was having a hard time coping! Although she was no longer in any danger, she still felt like it. Her body was in constant fight-or-flight mode.
The first time I saw Susan, she cried the entire session. Because she was so distraught, I only asked her a few key questions about her general health and gave her a treatment specifically for trauma. She was calmer within minutes, and I was able to find out about some of her other medical issues. Susan also had menopause symptoms and burning urination upon waking up. She was addicted to cocaine and had been for almost twenty years. Susan also had severe insomnia and sweated through her pajamas every night. Her inability to sleep more than three hours a night was partly emotional, partly due to menopause, and partly due to her use of cocaine. Somehow all of the medications Susan was taking didn’t seem to help. Her medicine cabinet was a mini pharmacy. She had been on Xanax, Klonopin, Celexa, and Ambien for as long as she could remember, and she had upped the dosage on all of them since her husband’s passing.
Susan didn’t have much of an appetite due to the cocaine use and stress. She admitted to not eating more than one meal per day. Even before the death of her husband, she had almost no desire to eat, and when she did eat, it was mostly sweets, refined carbohydrates, and coffee. She rarely ate any whole foods or vegetables. Even though she ate very little, Susan had some issues with weight gain. I concluded it was mainly because her metabolism had slowed down due to thirty years without proper exercise, as well as insufficient nutrients and calories.
That first week Susan received four acupuncture sessions, then we gradually cut back as she felt calmer. I gave her a patented herbal formula to address her panic attacks and help her sleep, and encouraged her to seek help with her addiction, recent trauma and loss, and mental health issues.
Initially Susan was not ready to improve her diet. I didn’t push her on this, because I was so concerned with her mental health. I did suggest trying to have a smoothie for breakfast to at least start off the day right, and suggested a meal plan for when she became more stable. It only took a few treatments and daily herbs before Susan made some big improvements.
My goal with Susan, and all my patients, is to give them realistic goals and lifestyle changes. Doing too much at once usually ends in failure and patients beating themselves up for that failure. That’s one main reason why extreme diets rarely work. You feel you’re being deprived of all the good things in life, and with some diets you end up limiting your caloric intake so much that it becomes unhealthy. As soon as you stop, you gain all the weight back and more. Then the guilt of not keeping it off or sticking to the diet makes it even worse.
I kept Susan’s dietary suggestions very simple. Susan knew that eating better would help her mental state, so she was somewhat motivated to make some improvements.
Breakfast: smoothie with almond, hazelnut, or hemp milk, or coconut kefir with strawberries, raspberries, flaxseeds, tahini, or almond butter; a pomegranate or pomegranate juice.
Lunch: whole grain Ezekiel or brown rice bread, lots of veggies, no mustard, Daiya cheese, tempeh or eggless tofu salad, or a rice tortilla with lots of veggies, brown rice, and guacamole.
Snacks: unsweetened trail mix, black sesame rice crackers, or celery and carrot sticks with nut butter, babaganoush, tofu salad, or hummus.
Dinner: green salad with miso dressing or oil and lemon (no vinegar); any veggies plus sesame, pumpkin, sunflower, and/or hemp seeds; lots of sprouts; baked sweet potato or yam; steamed spinach with garlic and a little olive oil; quinoa or red rice with sautéed veggies.
Susan’s progress, as with all my anxiety patients, was drastic. From the first treatment, when she immediately calmed down and stopped crying, her heart rate slowed and she was able to breathe. That first week she had only two mild anxiety attacks and no full-blown panic attacks. After six weeks she stopped taking all of her medications except Ambien and had only mild anxiety when she thought about her husband. No more panic attacks. She became sober three years later. Susan still comes in for monthly treatments to stay balanced and prevent any kind of relapse. If she’s having a stressful time, such as the anniversary of her husband’s passing, she comes in weekly.
Recap of Susan’s Fire symptoms: panic attacks, insomnia, addiction, burning urination upon waking, menopause.
As you can now see, even the worst cases can see big improvement with just a few lifestyle tweaks. If you’re feeling overwhelmed about your life or your mental or physical health, TCM can help. Also, remember to be gentle with yourself when going through something as challenging as a breakup or death of a loved one. Increase the number of Fire element–promoting foods in your diet (see lists at the beginning of this chapter), and you’ll feel calmer and more carefree. A happy heart means a happy mind.