Introduction
Rise employs a holistic approach to health; this means that we consider the whole person – body, mind, and spirit – in the pursuit of optimal health and wellness. We believe that a person’s overall health is dependent upon his/her physical, mental, and spiritual health; an imbalance in one will necessarily and negatively affect the others. Thus, achieving balance and integration among our patients’ and clients' bodies, minds, and spirits in order to treat and prevent illness and injury is our primary objective. The pursuit of this goal is guided by the overarching philosophy of Yin and Yang (阴阳), represented by the famous Taiji symbol (太极图) (Figure 1). The purpose of this article is to illuminate our approach to achieving balance in and integration among the body, mind, and spirit in order to restore health and prevent illness.
Figure 1. The Taiji symbol represents the opposing, interdependent, mutually-consuming,
and intertransforming relationship between Yin and Yang.
The Body
Physical health is dependent upon both structural and visceral balance. Thus, our approach to achieving balance in the body is centered around traditional Chinese medicine (TCM), which balances the internal environment according to the Yin Yang, Five Elements, and Internal Organ* theories, and structural integration, which balances the musculoskeletal system by manipulation of myofascial meridians. [1] Both systems increase the efficiency of information transfer through the neural, vascular, and connective tissue networks and use them to affect the entire body. While the specific applications of each system vary with each patient/client and his/her unique pattern of symptoms, two treatment principles are applied universally: (1) improving energy metabolism and (2) improving structural integrity and movement efficiency.
* Note that the Internal Organs in TCM differ from the conventional understanding of internal organs; the Internal Organs each represent a complex of functions and physiological processes. For example, the Kidneys in TCM may include the functions of the kidneys, adrenal glands, and other organs, as well as a multitude of physiological processes that are involved in water regulation, genetics, bone health, etc. In this article, I will differentiate the TCM Internal Organs from conventional organs by capitalizing the TCM Internal Organs.
Energy Metabolism
Energy metabolism is the overall process by which cells acquire and utilize energy needed to stay alive; as such, it is of central importance to physical health. Increasing the efficiency of energy metabolism is, therefore, beneficial to all systems in the body; this means that, as healthcare providers, one of our primary objectives in treating any patient/client is to improve the patient/client’s ability to convert food and air into usable energy and to efficiently use that energy to supply all bodily functions.
Cellular Respiration
Cellular respiration is a set of metabolic processes that convert chemical energy from nutrients and oxygen molecules into adenosine triphosphate (ATP), the primary carrier of energy in cells. Thus, in order to improve a patient/client’s ability to convert food and air into usable energy, we must increase the efficiency of cellular respiration by regulating respiration and digestion. We use both TCM and structural integration to achieve this result.
TCM utilizes a variety of treatment modalities, such as acupuncture, manual therapy, and herbal medicine, according to the Yin Yang, Five Elements, and Internal Organ theories, in order to restore balance to the body (for more information on these theories, see our articles “What is Qi? – A Scientifically-Minded Acupuncturist’s Perspective” and “The Five Elements Theory”). While an in-depth explanation of TCM theory, treatment principles, and mechanism of action is beyond the scope of this article, the application of which varies with each patient/client, a brief introduction to how TCM can be used to improve cellular respiration is in order. According to TCM Internal Organ theory, the Lungs, which regulate respiration and Qi, and the Spleen, which regulates digestion and is the root of Post-Heaven Qi, work together to produce True Qi (真气, Zhen Qi), the Qi that is said to ultimately flow through the acupuncture meridians and can be equated to ATP. [2] Therefore, to improve cellular respiration, we must enhance the functions of the Lungs and Spleen. This is done by restoring balance to these Organs according to the Eight Principles, which consist of four pairs of opposing categories: Yin/Yang, excess/deficiency, hot/cold, and interior/exterior (for more information on the Eight Principles as well as other TCM diagnostic and treatment methods, see our article “Preventive Medicine – The True Strength of Eastern Medicine”). True Qi assumes two different forms – Nutritive Qi (营气, Ying Qi) and Defensive Qi (卫气, Wei Qi). Nutritive Qi nourishes the Internal Organs and the whole body. Defensive Qi protects the body from exterior pathogenic factors and is regulated by the Lungs, which is also related to the skin. The Lungs’ corresponding Yang Organ is the Large Intestine, which, in modern medicine, is known to house a significant portion of the immune system in the form of the gut microbiome. Thus, one of the functions of the Lungs and Large Intestine equates to the function of the immune system, and cultivating a healthy and diverse microbiome is of central importance to health (for more information on the microbiome, see our article "Harnessing the Second Brain – 3 Ways to Nurture the Mind-Gut Connection and Use It to Cultivate Wellness"). As a result, enhancing the functions of the Lungs and Spleen (respiration and digestion) will improve cellular respiration and, by extension, the function of the immune system and the body as a whole. Depending on the condition of the patient/client, a variety of treatment modalities can be applied to achieve this result, including acupuncture, manual therapy, herbal medicine, lifestyle modifications, and meditative exercises (e.g., mindful breathing).
An important component of structural integration is the assessment and opening of the breath. The thoracic cavity, which houses the lungs, can be thought of as a box, formed by the ribcage, the vertebral column, the sternum, and the diaphragm. Freeing each dimension of the thoracic cavity (i.e., front/back, top/bottom, and sides) from structural restrictions allows the lungs to effortlessly expand to their full capacity. According to Thomas Myers’ Anatomy Trains, this is done by lengthening and balancing the myofascial meridians that run through the thorax, namely the Superficial Front Line (SFL), Superficial Back Line (SBL), Deep Front Line (DFL), and Lateral Line (LL). (Figure 2) [1] Balancing these lines, particularly the DFL, part of which contacts the visceral body, will also benefit digestion and other visceral functions.
Figure 2. (A) SFL (B) SBL (C) DFL (D) LL [1]
Energy Usage
The other half of energy metabolism is the set of anabolic processes that uses the energy produced during cellular respiration to drive the physiological processes that sustain life. Increasing the energy efficiency of these vital processes is, therefore, crucial to improving energy metabolism. This is achieved by ensuring that each organ functions smoothly, interorgan functional relationships are balanced, and biological information is efficiently communicated among the organs through the neural, vascular, and connective tissue networks.
Imbalances within and among the Internal Organs, even when they do not manifest as “serious” symptoms, cause the body to expend more energy when performing basic bodily functions. Thus, the primary objective of TCM is to achieve balance in the body. In TCM, each Organ system is evaluated for its state of balance according to the Eight Principles based on the physical manifestations of imbalance exhibited by the patient/client. Because the Internal Organs are intimately interrelated, the functional relationships among the Internal Organs are also assessed in order to determine the root cause of the imbalance. For example, a patient/client who is abnormally stressed may present with signs and symptoms such as fatigue, indigestion, constipation, loose stools, insomnia, breathlessness, irritability, and reduced immune function. Although the primary symptoms are not directly associated with stress, stress may be the root cause. According to the Five Elements and Internal Organ theories, stress causes the Liver (Wood) to enter a state of excess, which causes the Heart (Fire) to enter a state of excess, resulting in insomnia. The Liver overacts on the Spleen (Earth), which causes it to become deficient, resulting in indigestion and fatigue. The Spleen is unable to nourish the Lungs (Metal), so it also becomes deficient, resulting in breathlessness and a compromised immune system. The Heart overacts on and the Liver insults the Lungs, which further compromises the immune system. The Heart insults the Kidneys (Water), affecting water regulation and accelerating the process of aging. The Kidneys insult the Spleen, inhibiting water absorption. For patients/clients suffering from such a pattern of symptoms, it is crucial to address the root cause, which, in this case, is stress, while also tonifying the deficient Organs and reducing the excess Organs. Simply treating the symptoms individually will lead to nowhere as long as the patterns of imbalance remain; the patient/client’s Organs will continue to function at a suboptimal level, resulting in reduced energy efficiency.
Biological signals are transmitted through the three networks that interweave every part of the body – the neural, vascular, and connective tissue networks. The neural network (i.e., the nervous system) transmits electrochemical signals; the vascular network (i.e., the circulatory system) transmits molecular signals; the connective tissue network (i.e., the extracellular matrix, cytoskeleton, connective tissues, etc.) transmits mechanochemical signals. Just as robust communication infrastructure allows for effective communication throughout the land, efficient signal transmission through these three networks improves communication within the body, increasing synergy and efficiency among various physiological functions. Electrochemical signal transmission through the neural network can be improved with acupuncture and therapeutic meditative exercises that strengthen the mind-body connection. Molecular signal transmission through the vascular network can be improved with acupuncture, herbal medicine, and lifestyle modifications (e.g., dietary therapy and exercise). Mechanochemical signal transmission through the connective tissue network can be improved with acupuncture, manual therapy (e.g., structural integration), and therapeutic exercises. Not only can these treatment modalities improve signal transmission through the networks, but they also rely on these same networks to produce their therapeutic effects. As a result, optimizing the neural, vascular, and connective tissue networks also enhances the therapeutic effects of the various treatment modalities.
Structural Integrity
Achieving proper balance and alignment in the body is conducive and equally important to optimizing energy metabolism and visceral balance in the pursuit of optimal physical health. Myofascial restrictions cause imbalances in the musculoskeletal system, manifesting as poor posture, restricted movement, and pain. Naturally, a person with a reduced ability to move freely through space necessarily requires more effort and energy to perform physical activities, from standing still to competing in gymnastics, than a person who is structurally uninhibited. Thus, freeing myofascial restrictions via acupuncture and structural integration is another important component of our approach to health. Ultimately, the goal of any structural work is to balance the compression and tensile forces in the musculoskeletal system, like in a tensegrity structure (Figure 3), so that standing and moving under the force of gravity becomes effortless. This greater economy and freedom of movement allows the body to allocate more energy to other functions and the patient/client to prioritize other aspects of life. Posture is also affected by a person’s mental and emotional state. As such, mental-emotional states can also become embedded in the physical form as structural restrictions. For example, people who are depressed often have a shortened SFL, which causes them to adopt a hunched posture, restricting the breath and resulting in low back and neck pain. Thus, another aspect of correcting structural imbalances is treating mental-emotional problems. Likewise, correcting structural imbalances can help treat mental-emotional problems.
Figure 3. Diagram of a tensegrity structure. [3]
The Mind
The nature of the relationship between the mind and the body has been debated since antiquity; some argue that the mind is merely the conscious product of brain activity, while others argue that it is a phenomenon that uses the brain as a vessel to enact its will. Despite these differences of opinion, it is universally agreed upon that the mind is housed primarily in the brain. While modern medical science differentiates the central nervous system from the peripheral nervous system, in reality, the entire nervous system is a single unit, an extension of the brain that insinuates itself into every part of the body. In vivo, the nervous system is inextricable, both in form and in function, from the rest of the body. In this way, the brain, and, by extension, the mind, is entirely interwoven with all of the other systems in the body.
The word “mind,” in Chinese, is 神 (Shen). Shen, however, can also be translated to “spirit” and “god.” In TCM, Shen is used in two ways: “First, in a narrow sense, Shen indicates the complex of mental faculties, which are said to ‘reside’ in the Heart. In this sense, the Shen corresponds to the Mind and is specifically related to the Heart. Secondly, in a broad sense, Shen is used to indicate the whole sphere of mental and spiritual aspects of a human being. In this sense, it is not only related to the Heart, but encompasses the mental and spiritual phenomena of all the other [Internal] Organs, notably the Yin Organs — that is, the Ethereal Soul ([魂] Hun), Corporeal Soul ([魄] Po), Intellect ([意] Yi), Will-power ([志] Zhi) and the Mind ([神] Shen) itself.” [2] Each of the Yin Organs is also associated with an emotion. The Liver is associated with anger; the Lungs are associated with sadness; the Spleen is associated with pensiveness; the Kidneys are associated with fear; the Heart is associated with joy. The Organ and its associated emotion are mutually related in that the emotion may negatively impact the health of the Organ, and the health of the Organ may provoke the emotion.
An in-depth analysis of the intimate relationship between the mind and body and how TCM is used to treat mental-physical disorders is beyond the scope of this article; however, it is the focus of our article “The Mind-Body Connection.” Although TCM treatment of the mind is quite complex and varies with each patient/client, two treatment principles are universally applied – (1) grounding and centering the mind and (2) strengthening the mind-body connection. These treatment principles are applied primarily through meditative exercises, such as mindful breathing and Zhan Zhuang (站桩).
Mindful Breathing
Mindful breathing cultivates awareness of the breath as well as transient thoughts and emotions. During mindful breathing, attention is focused on the breath – its natural rhythm and the sensations felt in the body as the breath ebbs and flows with each exhale and inhale. Our patients/clients are taught how to breathe naturally and deeply into their abdomens (as opposed to their chests); they are also taught how to visualize “sending the breath” to various parts of the body and exhaling “negative energies.” Focusing on the breath in this way strengthens beneficial neural pathways and enhances gas exchange in the lungs, which also improves energy metabolism. Inevitably, thoughts and emotions come in and out of attention while practicing any meditative exercise. Our patients/clients are taught how to observe the stream of consciousness from a detached, almost third-person perspective. In the beginning, many find themselves distracted by these thoughts; however, through consistent practice, they develop the ability to choose to pay attention to or ignore them. This grounds and centers the mind, making our patients/clients more focused and less susceptible to emotional fluctuation and its accompanying effects on health. Patients/clients are encouraged to practice mindful breathing at certain times of the day as well as during acupuncture and manual therapy treatment.
Zhan Zhuang
Zhan Zhuang literally translates to “standing like a post.” Its most basic form involves simply standing like a post or a tree, reaching upward, yet firmly rooted to the ground. Our patients/clients are first taught how to assume a proper stance, called Wu Ji (无极) (Figure 4), in which one visualizes being suspended from a point on the top of the head and being rooted into the ground downward from the knees. Patients/clients are then taught how to move into the first practice position (Figures 5 and 6), in which one visualizes resting on a set of imaginary balloons. Mindful breathing is also incorporated into Zhan Zhuang practice.
Figure 4. Wu Ji stance. [4]
Figure 5. First position. [4]
Figure 6. Visualizing resting on imaginary balloons. [4]
While this practice of standing still may appear unproductive, it is actually a powerful and strenuous exercise for cultivating both the mind and body. This seemingly simple task places the mind and body in a minor but constant state of stress. Beginners to the practice will fatigue and lose focus within a few minutes; however, through consistent training and proper guidance, they will eventually develop the ability to physically and mentally relax in this position, as if resting on a La-Z-Boy, and ignore their stream of consciousness. Once they have developed this ability, the mind and body are much better able to endure the stresses of daily life. Having mastered the first position, patients/clients can then, should they choose to, move on to training Ba Duan Jin (八段锦) and progress through the sequence of Zhan Zhuang positions.
The Spirit
Spiritual development means something different to everyone. For us, the spirit is the part of human existence that seeks meaning in life and drives our need to be a part of something bigger than ourselves. As such, spiritual development includes any activity that gives life meaning and “fills the soul,” such as practicing religion, building meaningful relationships, and serving the community. While Rise is not a religious or spiritual healing center, we believe that by freeing our patients/clients of physical, mental, and emotional imbalances, we allow them to focus on their spiritual development, whatever that means to them. We also engage in our own spiritual development by striving to be a positive force in our community. To this end, we serve our community at large by promoting healthy lifestyle choices among the general public, educating fellow healthcare providers about acupuncture as an alternative to opioid pain medications, and supporting our homeless community, active military, veterans, and first-responders. We regularly host community service events as well as free seminars and workshops on topics ranging from nutrition to therapeutic meditative exercises; we encourage our patients/clients to participate in these events as doing so will benefit their bodies, minds, and spirits. If you are interested in attending these events, subscribe to our mailing list at the bottom of this page and/or follow us on social media.
Proactive and Preventive Healthcare
The current healthcare mindset in the West is predominantly reactive. There are two primary reasons for this reality: (1) patients are not proactive in managing their health and (2) the diagnostic criteria utilized in allopathic medicine are too limited. People in western countries commonly do not seek medical intervention until serious symptoms arise. At this point, disease prevention is no longer relevant. There needs to be a paradigm shift in the healthcare mindset, from reactive to proactive, of both patients/ and providers. Not only do we, as a society, need to promote healthier lifestyles, but we also must encourage people to seek regular medical assessment. However, allopathic diagnosis is currently centered around the identification of disease based on physical examination, laboratory findings, and imaging studies. While these methods are extremely powerful for diagnosing and monitoring diseases, they do very little to prevent them. Patients are considered to be in good health so long as they do not present with any significant symptoms and their vital signs and laboratory findings are within the normal ranges. However, once a condition has progressed to the point where it can be detected by these tests, prevention is already out of the picture.
TCM, on the other hand, is based on a system of balance. When a system is balanced, it is considered to be in a state of health; when a system is unbalanced, it is considered to be in a state of disorder. Patients/clients are assessed using the diagnostic methods of inquiring, inspection, auscultation, olfaction, and palpation. Based on the patterns of signs and symptoms observed, TCM practitioners determine the nature of the disorder and which Internal Organs and/or meridians are affected. In many cases, these patterns may not register as abnormal in a physical exam or laboratory findings. As a result, an allopathic physician may consider a patient/client to be healthy, whereas a TCM practitioner may find the same patient/client to be in a state of disorder and, therefore, may be able to correct the imbalance before serious symptoms arise, thereby preventing disease. Because of this, we encourage everyone to seek regular medical assessment from both allopathic doctors and TCM practitioners. For more information on the preventive power of TCM, see our article “Preventive Medicine – The True Strength of Eastern Medicine.”
Case Study
Let us conclude this article with a case study that illustrates how we help our patients/clients balance and integrate their bodies, minds, and spirits. A 77-year-old female retiree presented with depression, breathlessness, palpitations, poor memory, reduced mental function, fatigue, poor appetite, nocturia, neck pain, low back soreness, and a general sensation of cold, especially in the low back. She also suffered from a lingering cold. Her radial pulse was deep and weak on both sides; her tongue was pale. Her demeanor was somber and apathetic. Her posture was hunched over. Apart from a slightly elevated blood pressure (125/80), her vital signs were within normal ranges. Her husband had passed away about one year prior to her initial consultation at Rise. She was brought to our clinic by her son, who was also one of our patients. Assessment of this patient at our clinic revealed patterns of Kidney-Yang deficiency, Lung-Qi deficiency, Spleen-Qi deficiency, and Heart-Qi deficiency. The root cause of the patterns was determined to be depression due to her husband’s passing. In terms of the Five Elements and Internal Organ theories, depression caused the Heart (which is associated with Fire and houses the Mind) and Lungs (which is associated with Metal, sadness, and immune function) to enter a state of deficiency, manifesting as palpitations, breathlessness, and reduced immune function; this, in turn, caused the Spleen (which is associated with Earth and digestion) and Kidneys (which is associated with Water, water regulation, and brain function) to also enter a state of deficiency, manifesting as fatigue, poor appetite, poor memory, reduced mental function, nocturia, low back soreness, and cold sensation. Considering her age, her Kidney function was likely already in a deficient state. Consequently, the primary treatment principles were to tonify Kidney-Yang, Lung-Qi, Spleen-Qi, and Heart-Qi, as well as to open her posture and to relieve her depression. A combination of acupuncture, manual therapy, herbal medicine, meditative exercises, and lifestyle modifications was applied. Palpation of the Kidney, Lung, Spleen, Heart, Stomach, Bladder, and Ren meridians revealed the following points to be particularly tender, indicating activation: KD-3, LU-9, SP-6, ST-36, HT-7, BL-13, BL-15, BL-23, and REN-4. Acupuncture with specifically-developed needle manipulations was applied to these points and to DU-20. Postural assessment revealed a shortened SFL and DFL, so structural integration and manual therapy focused on lengthening these myofascial meridians and balancing them with the SBL and LL in order to correct postural alignment and open the breath. A customized herbal medicine formula, which included herbs such as ginseng (人参, Ren Shen), ginger (生姜, Sheng Jiang), cinnamon (肉桂, Rou Gui), and atractylodes (白术, Bai Zhu), was prescribed to correct the identified patterns of imbalance. Meditative exercises, namely mindful breathing and Zhan Zhuang, were applied to ground and center the mind as well as to integrate the body and mind. Yoga was also applied to achieve this effect and to lengthen the SFL and DFL in order to open the breath. Lifestyle modifications, such as dietary therapy and regulating sleep habits, were applied to help relieve her fatigue, indigestion, and reduced mental function. She was also encouraged to participate in a few of our community service events as a way to “lift her spirits;” participation in these events seemed to lift her mood considerably.
Post-treatment evaluation of this patient revealed a 40% improvement in energy levels, low back and neck pain, breathlessness, and palpitations after the first treatment and 95% improvement of all symptoms after twelve treatments. After twelve treatments, the patient’s demeanor and posture showed marked improvement. She returned monthly for reassessment and maintenance treatments. She maintained a 90-100% improvement of all symptoms, depending on her mental-emotional state.
References
[1] Myers, Thomas W. (2011). Anatomy Trains. London: Urban & Fischer.
[2] Maciocia, Giovanni. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. Edinburgh: Churchill Livingstone, 1989. Print.
[3] Sultan, Cornel & Stamenović, Dimitrije & Ingber, Donald. (2004). A Computational Tensegrity Model Predicts Dynamic Rheological Behaviors in Living Cells. Annals of Biomedical Engineering. 32. 520-30. 10.1023/B:ABME.0000019171.26711.37.
[4] Lam, Kam Chuen. The Way of Energy. Simon and Schuster, 1991. Print. ISBN 0671736450, 9780671736453.