Psychosomatic Medicine

Acupuncture chart from Chinese medical text circa 1340s A.D.

There is nothing worse than going to a doctor with a host of symptoms and being told there is nothing wrong with you. Many people who appear on the program, Mystery Diagnosis, (my second Discovery Health obsession next to the The Food MD) have had this experience. I recall one particularly disturbing episode, where a young woman complaining of extreme gastrointestinal distress was prescribed an anti-depressant by one of the many doctors she sought answers from. Confused, she asked how these would help her to which the doctor responded that her condition was basically all in her head. When a physical illness or condition is caused by or aggravated by a mental factor it is termed psychosomatic. Essentially, that is how this young woman’s doctor viewed her illness. Many years later, she was properly diagnosed with severe endometriosis, a condition where the cells of the uterus grow in other places of the body causing cramping, severe bleeding and infertility to name a few. In her case, the cells had grown into and over parts of her GI tract. She had a full hysterectomy and a section of her large intestine removed in order to reclaim some quality of life. Take that, anti-depressants!

As you can glean from the above story, defining an illness as psychosomatic carries with it an intense social stigma here in the west, even though almost all physical illnesses have mental factors that determine their onset, presentation, maintenance, susceptibility to treatment and resolution. When doctors dismiss symptoms like in the case of this young woman, the rest of the world follows suit. The person who is suffering internally and externally is labeled “dramatic” or even worse, a liar. For thousands of years, Chinese medicine viewed the psychosomatic as the greatest key to diagnosing deeper illness and imbalance in the body. The strength of the nervous system and physical state of the individual (including their environment) is assessed in order to understand the degree in which an organ or a system is affected. Every symptom is taken into account and treated seriously, with the objective being to restore balance. Moreover, the eastern approach considers how interconnected the body and mind are.

The biggest physical bully is emotional stress, which can infiltrate suddenly or slowly, over a long period of time. Even from a western perspective, stress can be incredibly destructive, wreaking havoc on connective tissues, digestion, vascular integrity and the body’s restorative sleep cycles if not managed properly i.e. not just a script for anti-depressants. In Chinese medicine, if the nervous system of the individual is weak, the symptoms of illness will be more psychological. On a physical level, the organ most affected by the emotional stress will be the weakest/dysfunctional one. Whatever the natural emotions associated with this organ are, they will become stronger and more destructive to the nervous system overall. As the organ breaks down, it takes the system it is associated with along for the ride, leading ultimately to disease. If the emotional stress comes on suddenly, it will affect the Heart and the Lungs. If it is gradual and long term, it will take a toll on the Liver, Spleen and Kidneys. Even more specific is the type of emotional stress broken down into these 5 categories: tense/chronic, shock/sudden, sadness, rumination and fearful emotion. This gives an even more precise view of the affected organs/systems in the body, further honing the treatment approach.

Our young woman with endometriosis would have been assessed as having a strong nervous system in the beginning, as her symptoms were predominantly physical. By the time she had gone to see the doctor who prescribed the anti-depressants, she was exhibiting a combination of physical and mental symptoms. This would signify that her nervous system was deteriorating. If she had also gone to see an eastern doctor from the get go, much of her later suffering might have been alleviated, as the weakest organ, her large intestine would have been addressed immediately with herbs and acupuncture/bodywork. Since organs are partnered in the Chinese system of yin/yang (solid/hollow), the untreated large intestinal dysfunction would have affected her lungs. This woman developed an eczema like rash all over her trunk and extremities that would get worse every time she had a violent bout of diarrhea. The skin is considered the 3rd lung of the body in Chinese medicine. This symptom developed 5 years after her initial bout of gastrointestinal distress. After ten years, she began to bleed copiously during her period, which lasted over two weeks. Initial blood tests had already indicated she was mildly anemic, but this massive blood loss rendered her immobile. Ironically, during this time, her large intestine dysfunction seemed to dissipate; however, as soon as the period would end, the violent diarrhea would return. At this point in her illness, the Spleen had become involved. Responsible for creating Blood/Qi and keeping things upright and in their proper place, it’s no wonder that when she finally got her diagnosis 15 years in the making, this was the most affected organ. (Note: One could even argue that the Spleen could have been the weakest organ overall, but I won’t complicate things for the reader) The cells of the uterus growing out of control outside of their proper place is demonstrative of Spleen weakness. The uncontrollable bleeding led to a massive loss of Qi that just couldn’t be replaced by her depleted system. The only solution, at that point, was to remove the uterus and large intestine to prevent the out of control cell growth from migrating elsewhere. While organ removal can have detrimental affects on the Spleen, it proved more harmful to keep the stagnation in there than to remove it. If I were this young woman, I would seek out an acupuncturist to help me keep my nervous system strong and balance the loss of the organs that were surgically removed. They would be able to recommend herbs and dietary changes to support her treatment. After watching this episode, it made me all the more fired up about Integrating Eastern and Western medicine. If East met West from the beginning, she and others like her would have been spared a lifetime of suffering. We would all have a better understanding of our body-mind relationship and keep the stigmatic tongue wagging at bay.

SOURCES & ADDITIONAL READING:

http://www.dragonrises.edu/learning-opportunities/articles-books/

http://www.psychosomaticmedicine.org/

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5 thoughts on “Psychosomatic Medicine

  1. So interesting! It’s so refreshing to learn about Eastern medicine since I’m currently so steeped in Western thought — but even as a PT student (versus medical), I do think it’s nice that we are encouraged to have a whole-body perspective with our patients. Maybe that’s because prescription medicine isn’t within our scope of practice? And your post just further underscores why it’s so important to have dual or multiple perspectives (east, west) when working with patients!

    1. I’m glad the post resonated with you. I have been studying this 1000 paged book all summer that has helped me to really immerse myself in the psychology of Chinese Medicine. My next one will be about herbs and nutrition 🙂

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