Yin is cold, damp, and feminine. Yang is hot, dry, and masculine. These forces are constantly in flow, balancing against each other.
Healing Body, Mind, and Spirit
We are learning that planet Earth can take only so much abuse, neglect, and toxic buildup before the natural ecological balance is disrupted. This same principle holds true for our health: the body can compensate for imbalances for only so long before a critical point is reached and it can no longer cope. Opioid use can be likened to a huge dump of poisonous chemicals into a river: not only are the negative results immediate, but bringing the river back to a healthy ecosystem may take years or even decades. Each individual part of the ecosystem must be restored before the river is healthy again.
TCM has always viewed the universe as a macrocosm and our body as a microcosm that mimics the universe. In TCM, the body cannot be separated from the mind and spirit. Wellness is not simply a matter of being disease-free; rather, wellness requires a thriving body, a clear mind, and a peaceful spirit. From this perspective, to overcome opioid dependency, the body, mind, and spirit must become unified in balance.
The origins of TCM are shrouded in mystery and myth; all we know for sure is that it dates back to before the time of writing. Originally practiced by priest-doctors known as shamans, who used primitive tools such as stones, TCM has developed into a well-documented, evidence-based system of medicine with important modern-day applications.
It is important to note that many theories of Chinese medicine have developed over the centuries, and practitioners agree on no single dogma. Rather, TCM has developed as a subtle and complex treatment modality whose wide-ranging applications have been repeatedly proven powerful and effective by scientific research.
Chinese medicine began developing a keen interest in opioid addiction treatment about 200 years ago. At that time, Western countries trading with China had developed concerning trade deficits, as they did not produce many commodities that China required. England resolved this dilemma by developing a drug trade targeting China, shipping in opium from India and other poppy-growing regions. While this would seem unconscionable today, at the time the West saw it as good economics and did not give much weight to the ethical implications. Realizing the detrimental effects of opium on its society, China pushed back, and the two historic Opium Wars of 1839 and 1856 resulted. While the true circumstances and motivations for those wars are argued to this day, the one fact that no one disputes is that these wars permanently altered the course of China’s history. (As often happens, present-day circumstances have an eerie similarity to historical events. Currently, the United States is experiencing the dire economic and social impacts of opioid addiction. In a reversal of roles, Chinese drug traffickers are the ones bringing opium to the West; several are under indictment by the U.S. Department of Justice on charges of manufacturing the highly addictive opioid drug fentanyl, selling it over the Internet, and shipping the contraband to the West by international postal services.)
In any case, the Chinese in the nineteenth century had powerful motivation for developing treatment strategies for opioid addiction, and they did so very effectively. Modern clinical studies show that TCM now has a wide spectrum of positive effects; as one group of researchers from the Chinese National Institute on Drug Dependence noted in 2006:
There are some advantages in using TCM for opiate detoxification, including less harmful side effects, high safety and ideal effects in the inhibition of protracted withdrawal symptoms and relapse. Co-administration of TCM with modern medicine shows some synergistic effects in detoxification. Many TCM for detoxification also have efficacy in the rehabilitation of abnormal body functions induced by chronic drug use, including improving immune function, increasing working memory and preventing neurological disorder. Given that TCM is effective in the prevention of relapse and causes fewer side effects, it may be used widely in the treatment of opiate addiction. 19
Modern Western medicine consistently produces miraculous healing feats through heroic high-tech interventions. This leaves us to question how an ancient, low-impact, low-tech medical system could play any relevant role in something as serious as the opioid epidemic or, for that matter, any modern health concerns. To understand the value of integrating TCM into our health-care system, it is important to describe the areas in which a subtle healing art such as TCM can complement and augment modern medicine. Here are a few examples of ways in which modern medicine and TCM collaborate for better patient outcomes.
Western medicine struggles in finding effective protocols that reverse chronic disease, eliminate pain, or cure addiction; these are the areas in which TCM shines. TCM is not appropriate for critical care; this is the area in which modern medicine excels. When looked at in this light, it is clear that the two healing modalities are perfect bedfellows.
Much of TCM has its foundation in Taoist beliefs. The Tao is an ancient text written by Lao-tzu, a philosopher of the sixth century B.C.E., describing how humans can live in harmony with nature to preserve health and happiness. It teaches that we can achieve a fortunate life only by maintaining lifestyle practices that promote balance: physical wellness, emotional equilibrium, and cultural peace. In line with that philosophy, the subtle yet profound effects of Chinese medicine work to bring balance to all the energies and substances that flow through and harmonize the body, mind, and spirit.
Yin and yang are two opposing yet complementary forces of the universe and everything in it, including the body. Each must be balanced relative to the other to ensure good health and vitality.
In terms of the body, yin is generally thought of as substance, and yang as energy. Yin is to yang like a log is to a fire: we must nourish yin so that our yang energy can burn long and bright. Yang makes things happen; yin provides the material necessary for things to happen.
In the body, yin is matter like blood, fluids, and tissues, while yang is energy and heat. Yin is cold, damp, and feminine; yang is hot, dry, and masculine. But there is no absolute yin or yang. As the yin-yang symbol shows us, every yin manifestation contains a bit of yang, and every yang manifestation contains a bit of yin. And these qualities manifest only as comparisons. For example, warm liquid is yang compared to cold liquid, but warm liquid is yin compared to hot liquid.
The inseparable forces of yin and yang are in constant negotiation, balancing against each other. They do not permit homeostasis but are constantly flowing and changing. In this way, they animate the human body.
All disease patterns pass through phases of yin and yang until they are resolved. If you sprain your ankle, at first it is yang: hot and inflamed. As this yang condition transforms to yin, the swelling goes down and the ankle becomes cold and stiff. Ideally, a balance of energies is eventually reached and the ankle is healed.
An opioid dependency often initiates a yin deficiency. Stress consumes yin in the body, and opioid use places physical stress on the body, and often emotional stress too (hiding a dependency can be stressful, as can trying to overcome the dependency). Without yin, yang suffers as well; continuing the previous metaphor, there is no log to feed the fire. Thus yang deficiency eventually results. Thus yin and yang deficiencies are common diagnoses for people recovering from opioid dependency. In order for them to fully heal, these energies must be revived and brought into balance.
Yin is cold, damp, and feminine. Yang is hot, dry, and masculine. These forces are constantly in flow, balancing against each other.
Qi, pronounced “chee” and sometimes spelled chi or ch’i, is our vital energy. Qi is the source of all movement in the body: fluids, energy, and matter ascending, descending, entering, and leaving. It circulates throughout the body following prescribed pathways, called channels or meridians.
Qi protects the body against external and internal pathogenic factors. When qi is insufficient or stagnant, the body declines and disease can develop. The goal of Chinese medicine is to ensure that qi is able to move freely, that it is moving in the correct direction, and that there is an abundance of it in the body.
We acquire qi through the food, liquids, and air that we consume. Certain herbs can stimulate it as well. We can manipulate qi flow in the body through acupuncture, which stimulates points on the meridians.
People who use opioid drugs for a long time typically do not eat well and do not treat their body well. As a result, qi production diminishes; qi deficiency is a common TCM diagnosis with those recovering from opioid dependency.
Essence, known as jing, is that aspect of the body that is the basis for all growth, development, and sexuality. Prenatal essence (sometimes called congenital essence) is that part of the body’s essence we inherit from our parents. Postnatal essence, which is akin to an inborn constitution, determines each of our growth patterns.
We are born with a finite amount of prenatal essence. It can never be replaced if it is lost, but it can be supplemented by acquired essence, which is derived from food and herbs. Proper lifestyle habits, such as sound sleep at night, help preserve essence.
If we do not cultivate qi properly, our body is forced to dip into its reserves of essence for the energy it needs. Unfortunately, people who use opioids on a regular basis generally do not eat well, sleep well, or practice any of the proper lifestyle habits necessary to maintain essence. As a result, they suffer from depleted essence, or what Western natural health advocates often refer to as adrenal fatigue or adrenal exhaustion. This is a common condition seen in opioid recovery, with indications of severe exhaustion that does not abate quickly.
The spirit, or shen, represents the forces that shape our personality, including psycho-emotional aspects. This is not the spirit of religious traditions; rather, it is our inner light. The heart houses shen, and it can be observed by trained practitioners through a certain brightness of the eyes. Shen disturbances generally refer to mental disorders.
Blood is a fundamental substance in the body that nourishes and moistens the whole organism. The body is dependent on a high quality and abundance of nourishing blood to maintain elastic skin, vibrant eyes, and healthy organs. Blood and qi are interdependent: qi moves blood, and blood nourishes qi production. When either is deficient, disharmony occurs, leading to ill health.
People recovering from opioid addiction often suffer from blood deficiency, indicated by lusterless skin, fatigue, vision problems, cold hands and feet, and so on. They also often suffer from blood stagnation, which happens when blood flow is sluggish or impeded and can cause sharp or stabbing pain, a purplish complexion and tongue, and numbness in the extremities.
The five elements — Water, Wood, Fire, Earth, and Metal — are the different aspects of qi, and together they make up the foundational energies of the natural world. Like yin and yang, the five elements are interdependent, and they rise and fall in cycles of relationship to each other.
The body is a microcosm of the natural world, and so these same elements and cycles are also at work within us. When the elements within us are out of balance with one another, the cycles are thrown out of balance, and disruption or disease results. If we know how to influence the elemental energies within us — and acupuncture, herbs, nutrition, meditation, and other aspects of holistic medicine do just that — we can influence the cycles within us and so bring the body back into balance. And indeed, in chapter 7 you’ll find protocols for treating opioid dependency by correcting elemental imbalances.
|
Element |
Organ |
Color |
Emotion |
|---|---|---|---|
|
Water |
Kidneys |
Blue |
Fear |
|
Wood |
Liver |
Green |
Anger |
|
Fire |
Heart |
Red |
Lack of joy |
|
Earth |
Spleen |
Yellow |
Worry |
|
Metal |
Lungs |
White |
Grief |
The concept of the organs in TCM is radically different from that of contemporary Western medicine. Understanding this difference is crucial, because the physiology and pathology of the organs are fundamental to understanding and treating disease. Chinese medical theory is not a quick study, but let’s break it down to the basics here. (Note: Throughout this book, TCM organ systems are capitalized to distinguish them from the Western conceptualizations.)
To begin, in TCM, an organ is actually a system, not a structure. Each organ system includes not only the physical organ, as understood in Western medicine, but also an array of interrelated functions and the channel that carries the energy of that system. For example, in Western medicine, the kidneys are organs that collect and excrete urine. In Chinese medicine, the Kidneys comprise the physical kidney organs and the Kidney channel (the energetic pathway of Kidney qi), and they are a storehouse of jing, the center of yin and yang, and the controller of the body’s waterways, among other things.
Chinese medicine even recognizes some organ systems that have no parallel in Western medicine, like the San Jiao (Triple Burner), an organ system responsible for metabolism.
All the organ systems can be divided into yin and yang categories:
Each organ system has an impact on the other organ systems when it becomes imbalanced; additionally, each organ has an impact on the emotions. Chinese medicine views each person as a holistic interactive entity rather than a collection of individual parts and pieces. This is how Chinese medicine is able to differentiate disease patterns and devise effective treatment strategies. One disease can have many different patterns depending on a person’s individual physiology, genetic dispositions, and lifestyle habits.
In this book, we focus primarily on the five organ systems that correlate to the five elements, because identifying and correcting elemental imbalances is a powerful method for treating opioid dependency and facilitating recovery. Let’s take a closer look.
Among other things, the Kidneys are the base of all yin and yang in the body. They control the waterways and regulate fluid balance in the body, store jing (essence), and produce marrow, which is essential for the formation of bone, the spinal cord, blood, and the brain.
The Kidneys correlate to the ears (they are said to “open into the ears”) and influence hearing. They also manifest in the hair; vital, lush, shiny hair is a sign of good Kidney health.
In people suffering from opioid dependency, two common Kidney imbalances are Kidney yin deficiency and Kidney yang deficiency. While it’s true that opioid use contributes to Kidney deficiency, it may also be true that many people who are prescribed opioids have preexisting Kidney deficiency. Chronic lower back pain, for example, a symptom of Kidney deficiency, is a common diagnosis for people who are prescribed opioids. 20
Common Symptoms of Kidney Imbalances
The Liver spreads the qi of all the organs in all directions, governing the free flow of qi that is necessary for the healthy function of the body. It controls the tendons and joints, providing them with nourishing blood, and correlates to the eyes (it is said to “open into the eyes”).
Since pain is a symptom of qi stagnation, Liver imbalances that cause qi stagnation anywhere in the body can contribute to pain syndromes. According to TCM, any pain in the joints indicates a Liver imbalance.
In people suffering from opioid dependency, Liver qi stagnation is common.
Common Symptoms of Liver Imbalances
Many societies through the ages have associated the Heart with love, as does TCM. In fact, TCM theory holds that the Heart governs all emotions, and a healthy Heart enables emotional and sexual warmth as well as the ability to feel joy. TCM also holds that the Heart controls the blood vessels, which more closely aligns with the Western medicinal model.
In people suffering from opioid dependency, a common Heart imbalance is blood and qi deficiency resulting in impaired cognition.
Common Symptoms of Heart Imbalances
TCM’s perspective on the Spleen energetic organ system does not closely align with Western medicine’s understanding of spleen and its functional aspects. According to TCM, the Spleen transforms and transports foods and fluids, making it central to digestion and nutritional absorption. If the Spleen does not manage fluids effectively, they can accumulate in the body, causing pain and a feeling of heaviness.
The Spleen controls the body’s “upright qi” — the power of qi to counteract gravity and hold the organs in place, preventing prolapses. It also manufactures blood, and Spleen qi keeps the blood in the vessels. Easy bruising — that is, blood spilling out from the vessels — is a diagnostic sign of Spleen qi deficiency.
In people suffering from opioid dependency, Spleen qi deficiency is a common Spleen imbalance.
Common Symptoms of Spleen Imbalances
The Lungs are said to “open into the nose,” and this energetic organ system includes the sinuses. It is closely related to the immune system and is central in defending the body from pathogenic invasions, like viral colds and influenza. The Lung system also correlates to the skin, and an imbalance in this system may be indicated by skin sensitivity.
In people suffering from opioid dependency, a common Lung imbalance is Lung qi deficiency.
Common Symptoms of Lung Imbalances
There is an understanding in Chinese medicine that wellness is a natural state and illness is the result of any number of pathogenic influences, emotional stressors, or poor lifestyle habits. When the body is in harmony or balance, it is able to resist pathogens and will not develop chronic diseases that can lead to premature aging and degeneration. Wellness in Chinese medicine does not simply refer to an absence of disease; rather, a healthy person is happy, healthy, and pain-free. In an effort to understand how to obtain wellness, we must first explore how a person can develop disease and imbalance.
From the perspective of TCM, everything in the universe is interconnected. Any changes in the universe, such as changes in the weather, influence humans. Weather is characterized by six energies that can cause disharmony in the body. The Six Pathogenic Factors, as they are known, are generally opportunistic; they cause disease only when our immune system is weakened.
Chinese medicine has recognized the influence of familial disease patterns for thousands of years, and practitioners have inquired about family history long before DNA was discovered. Some people are under the false perception that genetic imbalances cannot be positively influenced. Just as a change in diet and exercise can improve the prognosis for someone whose parent has had a heart attack, Chinese tonic herbs and other medical techniques can improve the prognosis for all types of genetically related diseases.
Improper eating habits can cause imbalances in many organ systems. Good eating habits are generally well understood in our culture, with wellness having become a popular topic in the media. Organic whole foods are always a good idea. Chinese medicine would advise against any excesses such as too much salt, which would damage Kidneys; too many spicy foods, which may damage the Lungs; or excessive amounts of iced drinks or raw foods, which can cause dampness and damage the Spleen.
Proper exercise is important in keeping blood and qi flowing. Brisk walking, qi gong, tai qi, and yoga are the preferred types of exercise in Chinese medicine. Vigorous exercise or very hard physical work can cause imbalances and should be avoided.
Having sound sleep during the night is a vital part of maintaining wellness in Chinese medicine. Broken sleep patterns, wakefulness at night, and prolonged sleep deprivation are all reason for concern.
In TCM theory, one of the major causes of disease is emotion, whether negative (e.g., anger, worry, fear, fright, anxiety, grief) or positive (e.g., joy). All of these emotions are normal, and everyone experiences them at different times. Emotional responses can cause disease and injure the vital organs if they are out of proportion to the situation or if they are chronic. Alternatively, if an organ system becomes deficient or out of balance, the related emotions can occur chronically. It is often a chicken-or-egg question: Did a bodily imbalance cause an abnormal emotional response, or did the emotions damage the organ system? All of the emotions originate in the Heart, and serious emotional disorders are considered to be disorders of Heart shen.
As we’ve discussed, in Chinese medicine, emotional wellness is as important to vitality and health as physical wellness. While it is well established that opioid use leads to physical deterioration, the relationship between opioid use and emotional/psychological health is less certain. Chronic opioid users have a higher-than-average rate of psychological and emotional issues, but whether those issues contribute to opioid dependency or are caused by it is still unknown. In fact, both may be true.
One 2010 study, an assessment of more than 1,000 recovering heroin addicts, concluded:
Addiction is a relapsing chronic condition in which psychiatric phenomena play a crucial role.. . . The hypothesis that mood, anxiety and impulse-control dysregulation [are] at the very core both of the origins and the clinical phenomenology of addiction should be considered, as well as the crucial role played by psychiatric manifestations as addiction progresses. 21
The study found that the participants could be divided into five groups based on their dominant emotional imbalances. Interestingly, the psychological profiles for those five groups aligned with the personality types of the five elements of Chinese medicine (Water, Wood, Earth, Fire, Metal). Practitioners of Chinese medicine have long worked with the five elements to reinforce emotional balance and psychological wellness in their patients. Because psychological influences have such a strong connection to opioid dependency, the five elements offer us a way to treat the addiction on a psychological level. Let’s take a closer look at each element in relation to the 2010 study.
Of the study’s participants, 22.3 percent reported dominant feelings of panic and anxiety such as “fear of travelling by bus, train or subway,” panic attacks with nausea and light-headedness, and social anxiety. For this group, the study’s authors noted, “Generalised fear is a feature, with the need to avoid certain things, places or activities in order to prevent panicking.” These are all classic symptoms of Kidney deficiency and a Water element imbalance.
A group comprising 19.7 percent of the study’s participants displayed violent outbursts with destructive aspects and physical aggression. Sometimes that anger turned inward, resulting in suicidal tendencies. As the authors noted, this group “longs for death.” These characteristics describe Wood influences, as this element correlates with the emotion of anger. The Liver is the yin organ of the Wood element, and this group displayed additional symptoms of Liver qi stagnation, such as restlessness and feeling upset much of the time.
This group, which comprised 19.4 percent of the study’s participants, had psychotic factors ranging toward extreme paranoia. They “have the impression that others stare at them or speak about them, may do something against them, . . . do not sympathise with them or approve of their behaviour. . . . These behaviours may be defined as psychotic as long as the patient is convinced that others control or influence their thoughts, in some cases actually being identified as imposed from outside that individual’s mind.” In TCM, this is a disorder of Heart shen. The Heart is the yin organ of the Fire element, and it is said to house the mind and all emotions.
This group, which comprised 14.2 percent of the study’s participants, was dominated by feelings of worthlessness and being trapped, marked by obsessive-compulsive behaviors, worrying, and an inability to concentrate. In TCM, the yi (intellect) is said to reside in the Spleen, which is the yin organ of the Earth element. An overriding theme in patients with Earth element imbalances is the feeling “No one cares about me,” which develops into a sense of worthlessness. Obsessive thoughts and behaviors are classic symptoms of Earth element imbalances. Additionally, the Spleen controls water metabolism in the body. When the Spleen is not functioning optimally, internal dampness begins to accumulate; mentally, this would manifest as a feeling of foggy-headedness, with difficulty concentrating.
This group, comprising 24.4 percent of the study’s participants, had dominant characterizations of somatization, or the manifestation of physical complaints without medical cause, sometimes resulting from the conversion of mental symptoms to physical ones. Somatization is often a feature of opioid withdrawal. These participants reported, among other things, feelings of breathlessness and chest pain, which are classic symptoms of a Metal element imbalance. The Lungs are the yin organs of the Metal element. Qi flow to the Lungs is most active between 3:00 and 5:00 a.m., according to TCM, and participants in this group reported that they “wake up early at dawn and cannot get back to sleep” — a specific symptom of imbalance of the Metal element. This group also experienced heightened interpersonal sensitivity; the Metal element establishes our personal boundaries, and those with Metal element imbalances can be hypersensitive to others getting in their personal space, literally or figuratively.
TCM has five primary branches of practice: acupuncture, herbal medicine, tui na (therapeutic massage), medical qi gong (energy healing), and nutritional therapy. A TCM practitioner will be a licensed acupuncturist (L.Ac.); the L.Ac. accreditation means that the practitioner has received a 4-year postgraduate degree (3 years if their school did not train in Chinese herbalism) and passed a national board exam through the National Certification Commission for Acupuncture and Oriental Medicine (or an equivalent state exam). Those with DAOM credentials (Doctor of Acupuncture and Oriental Medicine) have, in addition to all that, another 2 years of study at the doctorate level of training in Oriental medicine.
Your practitioner will ask you to fill out a wide-ranging questionnaire and ask you a number of questions relating to your health and symptoms. He or she may also examine your tongue, take your pulses, and palpate areas for tenderness.
Many patients new to acupuncture are nervous about the treatment. There is no need for worry. Licensed acupuncturists are highly skilled. The needles are hair thin. They typically cause no pain, though you may feel a slight pinch when they are inserted. The needles usually stay in place for 20 to 30 minutes while you relax, and then the practitioner will gently remove them.
Your practitioner may utilize tui na massage or medical qi gong healing techniques during your treatment. He or she may give dietary recommendations or herbal prescriptions as part of your healing plan. Other practices are also often prescribed in treatment, including moxibustion, Taoist meditations, and tai chi exercises.
As you’ll learn in chapter 3, acupuncture and other TCM healing techniques are generally not single-session cures. Your practitioner will work with you to set up a schedule for ongoing treatments that will work, over time, to bring your body and all its energies into balance.