There was always one question that was asked at my school’s clinic during the patient’s interview by the practitioner in charge and his following students. This question was: "Do you have stress in your life?" And I always remember the look on the patient’s face expressing his/her surprise. Most of the time, the answers would be with a little giggle: "Yes, life is stressful. No?" "Don’t you have stress?"
I guess that question was never asked correctly and no one was interested in developing the question further. Our reactions were always very predictable "This person suffers from Liver Qi stagnation" or "Xiao Yao San is your formula of choice". Stress can express itself in so many different ways and it is really important to listen to how stress is expressed in our client’s life.
It is well established by contemporary medicine that stress can be the cause of a wide range of diseases. However, stress is an important part of how our body responds to external stimuli with the activation of the sympathetic and parasympathetic nervous systems. In itself stress is a good thing, but chronic stress stimulation of the autonomic nervous system has a very bad effect on bodily functions. Therefore, diagnosing a client’s chief complaint on the only basis of stress will not be sufficient. We need to further explore and discern the cause of the stress. Stress is a rather broad concept and healing and management can be tricky.
Chinese medicine’s strength dwells in the holistic approach to the treatment of dis-ease in a person and is rooted in the body-mind-spirit connection. We have to investigate and differentiate the patterns exhibited by the person and try to keep in mind the big picture. Many times, the client’s case might be quite complex, but by sticking to the basics of Chinese medicine, a categorization of the symptoms exhibited into patterns will emerge and with it the appropriate treatment plan.
As our teachers would say: "Treat the root and not the branch", or "Stop looking/searching for information, slow down and observe". Of course, further investigation of how stress translate in the client’s mind and body by asking ample questions will give very valuable information and help us direct our intention better by choosing the appropriate acupuncture point or the appropriate herb for the design of a formula.
In my own practice, the patterns I have so far encountered were mostly patterns of blood deficiencies, Qi deficiency, yin deficiencies with heat, yang deficiency, and some excess heat. Very often, I have seen clients with tendencies to worry too much, others suffered from depression, or those who pushed themselves to the limit without being aware of it. In those cases, I have had good responses with herbal formulations such as Suan Zao Ren Tang, Si Wu Tang, Ba Zhen Tang, Zhi Bai Di Huang Wan and Tian Wang Bu Xin Dan.
I remember this person who came to me with complaints of intense stress, anxiety, depression and dread of sunlight and summertime. Only a few other elements of information allowed me to make a decision on the pattern exhibited and the treatment plan to follow. I sent this client home with Tian Wang Bu Xin Dan. I saw this person again several weeks later with a big smile on her face. She was finally able to enjoy and have some peace in her life. Others responded well with such formula as Chai Hu Jia Long Gu Mu Li Tang, a Shang Han Lun formula.
Another aspect to take into consideration is people’s diet. Our modern diet is so rich in carbohydrates and stimulants that it impacts greatly our bodily functions creating such conditions as inflammation and adrenal depletion. In Chinese medicine, we know that sweets can damage our spleen and kidney systems and therefore create imbalances.
And again the strength of Chinese medicine is the importance that body and mind are part of the same whole. One has an effect on the other and vice versa. If our Spleen system is put out of balance by bad dietary habits, our emotions are going to be disturbed and worry and stress issues will occur. Diet is now a big part of "functional medicine", a new branch of modern medicine that emphasizes preventative care. I often include dietary recommendations for my clients depending on their constitution and condition.
However, it is important to emphasize that supplementation with herbal formulas and a dietary change might not bring panacea. It will help patients reach a plateau in the management of stress, but might not eliminate completely those overwhelming feelings. This is when such concepts as mindfulness ("being in the Now") are of primal importance. The rest of the path to better stress management needs to go through a re-learning or re-programming process of one’s nervous system and thought process, as well as a growing awareness of one’s emotional and psychological states.
To help in this re-programming process of the mind, meditation and psychotherapy can be very useful tools to overcome disabilitating crises. I also recommend the practice of such activities as Yoga or Tai Chi Chuan on a regular basis. Those practices help in relaxing the body and mind. All of those modalities help in increasing our thought process awareness and in return help in a better control of those thoughts. By controlling our mind, we can reduce the effect of stress in our life and in our body enabling better bodily functions and better enjoyment of life.
In conclusion, stress is complicated to treat so using several modalities in conjunction can be quite beneficial.
Frederic Thouvenin is a certified licensed acupuncturist who has a Master of Science in Traditional Chinese Medicine and Physics as it applies to Western Medicine. His interest in Chinese medicine stemmed from his early education in Chinese Internal Martial Arts. As the lead herbalist and consultant at the sorely missed Elephant Pharmacy in Berkeley, Mr. Thouvenin showed his commitment to serving his community and sharing his knowledge of TCM.