Trekking the Heart's Terrains . Stress & Trauma according to TCM.

In recent years, Trauma Informed Care (TIC) has come to be recognized as an important factor in Public Health. Policy makers in healthcare and other sectors of society are beginning to take this reality to heart. An example would be the recent "paradigm shifting" decision, just this past month, by the LA Board of Supervisors to forgo a $2.2 billion dollar prison in favor of community based mental health solutions! This is a sign of great progress considering that in modern Biomedicine, recognizing emotions as an etiology of illness did not enter the conversation until the 1960's with Han Seyle's introduction of General Adaptation Syndrome (GAS).

In terms of public adoption of TCM and acupuncture to treat stress and trauma, we saw the US Department of Veterans Affairs begin researching and applying acupuncture to treat PTSD following the 9/11 national tragedy. To date, it has been almost 2 decades and a number of systematic reviews and meta-studies on acupuncture's effect, including a 2017 systematic review by Sean Grant et al., have demonstrated the effectiveness of this TCM modality.

There is also a great book by one of the early TCM pioneers in the VA call "The Tao of Trauma" that we highly recommend! In this book, Alaine Duncan shows how modern theory and approaches such as polyvagal theory and somatic experiencing are confirming the clinical wisdom that has been practiced for centuries in Traditional Chinese Medicine.

Emotional Trauma from a TCM perspective will also be the topic for our upcoming March podcast, so here we'll try not to give away too many spoilers. So it'll just be a short outline here on how TCM views emotional trauma which we call 七情內傷, Seven Feelings Internal Damage.

1. There is a interdependence among all three levels of human being . (Physical/Physiological/Psychological 精氣神)

心“在志為喜”、肝“在志為怒”、脾“在志為思”、肺“在志為憂”、腎“在志為恐”。喜怒思憂恐，稱為“五志”。

In the Heart it is called Joy, in the Liver it is called Anger, in the Spleen it is called Worry, In the Lung it is called Grief, In the Kidney it is called Fear. Joy, Anger, Worry, Grief, Fear. These are called the Five Emotions.

血有余則怒，不足則恐，肝氣虛則恐，實則怒。心氣虛則悲，實則笑不休

Blood when excess Anger arises, if not sufficient then Fear arises. Liver Qi when deficient result in Fear, excess then Anger. The Heart Qi when deficient there is Sadness, when excess there is restless laughter.

2. There is a distinction between the Five Emotions and the Seven Feelings. The Five Emotions are our instinctual reactions arising from the Kidney, they come and go in response to the environment. "Why Zebras don't get Ulcers" is an interesting book on physiology that can shed light on this distinction for the modern reader. In brief, animals can face life and death events daily but then are able to shake them off , discharge the trauma, and go about their day.

Human beings are more conscious of our emotional experiences, for good or bad, sometimes the 5-Emotions can leave an imprint on our Pysche. These conscious emotions are called in TCM as the Seven Feelings. When events are adverse, they can cause Psychological Damage, 傷神. That is why in TCM, emotional trauma have traditionally been called 七情內傷, Seven Feelings Internal Damage.

Seven Feelings: Joy, Anger, Grief, Worry, Sadness, Fear, Shock

七情 : 喜、怒、憂、思、悲、恐、驚

The Heart is the Sovereign of the Five Viscerae and the Six Bowels...When the Heart is moved the Viscerae and Bowels are likewise shaken up.

心為五臟六腑之主 ...心動則五臟六腑皆 搖

Anger causes Qi to Rise, Joy Slows the Qi, Sadness causes Qi to Dissolve, Fear causes Qi to Descend, Shock causes Qi to be Disregulated, Worry Knots the Qi

怒則氣上、喜則氣緩、悲則氣消、恐則氣下、驚則氣亂、思則氣結

The TCM statements above are now being proven by parallels in modern approaches to trauma treatment which are now discussing concepts such as Heart Coherent States , Autonomic Nervous System (ANS) Disregulation . The ANS when traumatized are said to be stuck in Sympathetic states and Parasympathetic states which has strong parallels to TCM ways of describing Yin-Yang and Qi Mechanism states. This has now become the standard language of trauma therapies such as Somatic Experiencing.

Emotional traumas manifest in the disregulation of the Heart, Liver, and Spleen and the Qi and Blood; we often encounter this

情志所傷，以心、肝、脾三臟和氣血失調為多見

This clinical pearl gleamed from empirical practice is now given Biomedical theory confirmation which in the West is being called Polyvagal Theory.

We hope you’ll tune in to our March podcast for more on Trauma and TCM. Let's embark on this trek together!

Look for Prescriptshens on iTune and Spotify.

Till then, Salud!!!

By: Hoang Tran