Note: As always, if you’d like to book an online appointment with me, click here or respond to this email and I will be more than happy to connect.
Hello Friends,
Today I want to follow-up on some concerns that were addressed in my previous newsletter, relating to the idea of the "root" (ben 本) and "branch" (biao 表) in Chinese Medicine. If you didn't get a chance to read it but would still like to, you can find all my past newsletters on my blog here. As mentioned at the end of last week's letter, in Chinese medicine symptoms are understood to be messengers, helping us to recognize and address deeper underlying imbalances. For this reason, the idea that in medicine we ought to suppress symptoms is largely absent from the Chinese medical tradition. This, as we shall see today, is equally the case for disharmony of the body and of the mind.
Illness and the Struggle to Adapt to Change
From the perspective of classical Chinese medicine, illness arises from the fact that we, as embodied beings, struggle to adapt to change. This is equally true of all illnesses. A trauma to the body from an external source, such as being hit or assaulted, is a change that the body cannot adapt to quickly enough. The tensing up of the body is a natural response to a rapidly changing situation and if this gripping is only momentary, as a healthy protective response to an impact, the body will be able to release afterwards, without getting stuck in a pattern of resistance.
However, this is often not the case, and the body can get stuck in a holding pattern after such an event, as it struggles to ‘let go.’ This same principle stands for other forms of illness as well. When the body is unable to adapt to the invasion of a pathogen from its environment by evacuating it in some way, illness ensues as the body mounts a response in resistance to it. Similarly, when the body cannot adapt to the presence of a certain food it has ingested, it gets sick. The inability to move with and respond appropriately to the changes our system is confronted with impedes our continued movement and free mobility, both physiologically and psychologically. A change in one's relational world that one cannot adapt to, such as the loss of a loved one, or a conflict in a friendship, can be the cause of illness on a psychological level.
The Problem with Analgesics
Because all illness is a way that the system struggles to adjust, proper treatment supports the body and mind in adapting to and skillfully navigating change. From this perspective, the widespread use of analgesics--drugs that remove or alter the experience of such as acetaminophen, aspirin, COX inhibitors, non-steroidal anti-inflammatory drugs (NSAIDS), and opioids--contributes to and enables resistance to change in the body. Simply put, numbing an experience is a form of resistance to it. This is not to say that analgesics have no place in medicine but, as previously mentioned, from a Chinese medical perspective responsible use requires addressing the underlying imbalance simultaneously. Unfortunately, Western medicine routinely employs substances in ways that have no notable therapeutic effect other than temporarily suppressing the experience of pain.
Opioids are a prime example of this suppressive effect. Opium husk was used in Chinese Medicine classically, and is classified as a sour, astringent, and slightly toxic substance that primarily affects the kidney, lung, and large intestines. It is used primarily for its ability to astringe the lungs for leakage of lung qi in cases of chronic cough, to bind the intestines to help treat diarrhea, and to stabilize the lower abdominal region (the lower jiao) to prevent urogenital leakage. Its pain relieving properties are traditionally acknowledged, but it was never prescribed as a long-term solution for pain. Opiate drugs in general are understood to have a strongly astringent and dampening effect on the "metal" viscera, the lung and large intestine, which in Chinese medicine are related to the aspect of the awareness known as the po, sometimes translated as the 'corporeal soul'. The po plays an essential role in the perception of somatic sensations, like pain. That these substances are understood to "dampen" this part of the mind speaks to its analgesic properties; dampness clouds perception, muting experience and obstructing sensation. This is why when people take opiates they become disconnected and dreamy, perceptually withdrawing and becoming numbed-out, sometimes lost in imaginal worlds that are disconnected from their immediate somatic experience. By strongly astringing and dampening the po aspect of consciousness, the wood aspect of consciousness known as the hun is also affected, which is strongly connected to the experience of dreaming, planning, visioning, and imagining. As such, opioids have the effect of muting the bodily, somatic dimensions of experience and disconnecting them from the more imaginal and visionary, dream-like aspects of experience.
Opioids neither nourish the body nor clear pathology to address the cause of pain; they merely suppress the experience of it by muting it clouding the mind in the process. As such, opioids do not help the body adapt to change, but rather to ignore it. This is the case for any medication that only suppresses symptoms without relieving them. From the perspective of Chinese medicine, this way of using substances is not truly medicine; for they create more layers of obstruction to clear perception, making it harder for the body and mind to adapt to the changes it is struggling with: they are examples of treating the branch only to allow one to ignore and suppress the root of the problem. Other pain management medications are the same, as are various other classes of drugs. This is certainly the case for the treatment of emotional and psychological pain.
Modern Psychiatry and the Cultural Process of Normalization
By and large, modern psychiatric drugs similarly fall foul of being branch treatments, for they rarely address the cause of psychological disturbance. If they did, they would not have to be taken indefinitely, as so many do. The widespread use of psychiatric medications has not only obstructed people's ability to experience their own mind and learn to adapt to the changes they are struggling with, but has resulted in a culture-wide resistance to the changes and transformations of the whole spectrum of the human condition. One of the effects of the widespread use of antidepressants and other anxiolytics, mood stabilizers, and ADHD medications has been a cultural process of 'normalization' in which the norms for feeling and behaving in contemporary Western culture are made tighter and less inclusive with the help of these drugs. In tandem with this narrowing conception of what is healthy, cultural ideals of human flourishing versus human suffering have also changed. Antidepressants and ADHD medications foster an ideal of a constantly positive, in-control, energetic, and socially competent personality that it is supposedly possible to achieve by taking these meds. As such, if one does not exhibit this type of personality, they are pathologized. Being melancholic, disorganized, or impulsive are no longer character traits as they used to be; now they are clinically diagnosable and treatable 'disorders.' The normalization of pharmaceuticals is part of a process of medicalization that constricts the domain of what is considered 'healthy' at the expense of previously acceptable behavior. As the scope of what is considered 'normal' in society gets narrower and narrower, less and less room is left for individual differences in emotional temperament and expression.
As part of this policing of what is normal, DSM categories have often reflected biases and bigotry (for instance, until 1973 homosexuality was classified as a disorder in the DSM). The DSM's relationship with pharmaceutical medicine is undeniable, and is especially clear when we consider that certain diagnostic categories have literally been created to market new classes of drugs, as was the case for the class of drug known as 'mood stabilizers,' a term originally created to market the anticonvulsant Depakote to a wider audience, which in turn necessitated the creation of the clinical diagnosis of Bipolar disorder.
Cultural critics and scholars have widely observed that Anglo-American culture is obsessed with 'happiness' as an ideal. Whereas many other cultures consider happiness to be a rather unsophisticated state, not necessarily indicative of a well-developed character, American society especially valorizes happiness as an end in itself. Consequently, those who do not constantly appear happy are considered disturbed, and with the increasing medicalization of such states, more and more Americans are on psychiatric medications simply because they cannot bring themselves to feign happiness. Our ideals of happiness serve the consumerist logic of the society we live in, for if happiness, rather than moral virtue, caring for others, contentment, or equanimity, is the goal of life, we are more susceptible to being sold products that promise us increased happiness and endless 'good times.' However, the quest for happiness is paradoxical, for it has been widely noted that to the extent we try to achieve happiness for its own sake, the less happy we tend to be. Trapped in a constant hamster-wheel, we strive for an elusive 'happiness' for our own consumption, which is forever just beyond our reach. Every advertisement promises happiness from a new product or experience, yet we just keep needing more, more, more. The social pressures to be happy are significant, and in certain sectors of American society, people are related to as inherently problematic if they do not constantly play the role of a happy person. Unable to fulfill the impossible ideal of happiness for its own sake, many people assume they must be pathological and so find solace in psychiatric diagnoses that assure them it isn't all their fault that they can't achieve the happiness everyone seeks; it is "just a problem with their brain chemistry." Thus, the status quo of cultural normalcy is re-established, and everyone can continue in an uncritical and unquestioning happy state, anesthetized either by drugs or by a constant stream of products to consume.
Addressing the Branch but Missing the Root
Because of this strange state of affairs, the happiness that people's lives are supposedly based on is incredibly fragile because it denies their full, lived, embodied experience. Spiritual traditions have long recognized that the price of wisdom and authenticity is often the willingness to undergo existentially uncomfortable states. It is only by deeply experiencing ourselves, including the dark and uncomfortable aspects of our being, that we become wise. The modern obsession with happiness and the pathologizing of anxiety and depression make this process all the harder. Instead of recognizing anxiety and depression as potential gateways into deeper self-understanding, authenticity, and wisdom, they are simply medicalized away. The fact of the matter is that anxiety and depression are very natural responses to situations, in which one does not feel respected, cared for, acknowledged, or when the society one lives in is violent, uncaring, or out of touch with what is most important in life. Sadly, such states are no longer understood to be symptoms worth listening to and investigating the root of, but only problems to be pathologized and suppressed medically. Because of this, many of the most sensitive and perceptive youths in our culture are being medicated precisely because they are having trouble adapting to the state of the world they live in, which they understandably find disturbing on many levels. Reductively considering brain chemistry to be the cause of psychological disturbance overlooks the relationship between social and political conditions and psychological pain and discomfort. The obsession with the rat race for achieving happiness for oneself alone keeps people stuck in a state of psychic pain, for deeper happiness and contentment do not arise from seeking happiness itself, but from living life well, in service to others, to the greater good, and for the sake of a higher calling.
In modern psychiatric medicine, the root causes of psychological disharmony are rarely identified, which is why psychiatric medications are not curative. Just like analgesic medications, many psychiatric drugs are considered "dampening" from a Chinese medicine perspective, masking the problem as long as one continues to take the medicine and does not develop a tolerance. The idea that psychological pain and existential confusion can simply be controlled and managed through drugs has resulted in an overmedicated population profoundly out-of-touch with themselves. It is a way of bracing against change, resisting embodied experience. Like physical symptoms, psychological imbalances usually result from subtle imbalances gaining momentum over time, and simply numbing them prevents us from discovering their more nuanced layers and, ultimately, their root.
Of course, Chinese medicine offers a different approach. Rather than simply suppressing symptoms, we aim to understand their origin. Through deep listening to the body, we use various diagnostic techniques to discern the root of these troubling manifestations of illness. This allows us to work with the body and mind to help transition the system into a more easeful state. Rather than managing and suppressing symptoms, we listen to and try to understand what they are trying to tell us.
Alright, that's all for today, folks.
have a meaningful week,
Aidan
Note: As always, if you’d like to book an online appointment with me, click here or respond to this email and I will be more than happy to connect.
Aidan Keeva, DACM, L. Ac.,
Doctor of Acupuncture and Chinese Medicine