Traditional Chinese Medical Psychiatry

For the fourteen years prior to relocating to Vero Beach, Dr. Robert closely collaborated with a Ph.D. Psychologist developing and refining Dr. Robert’s approach to TCM Psychiatry. In Traditional Chinese Medicine (TCM), it is understood that emotional and physical health are closely allied and are, in fact, wholly interdependent. Illness arising from an organic or somatic source will eventually lead to or create an emotional or psychic response, for instance, chronic pain of any type is always followed by a depressive state.

The converse is also true. Chronic depression eventually leads to a breakdown of the immune system and metabolic decline that can lead to conditions that range from an increased susceptibility to colds and flu to obesity and heart disease.

In TCM, some of the relationship, between mental emotional and physiological states can be loosely summarized as follows;

Anxiety and depression tend to damage the liver or can be the result of liver disease.

Grief and sorrow tend to injure the lungs and can be due to lung injuries like asthma and bronchitis.

Obsessive compulsive thinking and behavior tend to damage the spleen and stomach or can be the result of a dysfunctional digestive system.

Fear, fright and paranoia suppress the function of the kidneys or can be caused by repression of the kidneys and adrenal function.

Too much of any emotional condition, especially in sudden bursts, tends to injure the heart. Even a pleasurable emotion can injure the heart. A weakened heart can make every emotional fluctuation a dangerous proposition.

Since emotion in excess is potentially responsible for a wide variety of disease condition, the Taoist sages have always counseled emotional moderation. The “middle way” is one of the fundamental concepts in Taoist philosophy but is often misunderstood in the West. The middle way is not Prozac; the Taoists did not advise that we live in an emotional vacuum in order to preserve the health and harmony. The lack of emotional outlet is as potentially devastating as the any one of the emotional excesses listed above.

Diagnosis of Illness and Therapeutic Principles


The general TCM approach to any illness involves diagnosing and correcting the imbalance within the meridian system, the Zang fu organ network, and the vital substances. The treatment methods usually include Acupuncture, Acu-tap, Moxabustion, Herbal medicine, and Qigong exercises to restore flow and balance.
In making a Zheng or pattern diagnosis, Chinese medicine physicians pay close attention to the constellation of each patient’s emotional and physical complaints, his or her preferences (dietary, climactic), constitution (genetic and postnatal contributions), and prevailing emotional expression and coping style. The history is supplemented with Chinese medicine pulse and tongue diagnosis. Although often called the “pattern” or “syndrome,” the Zheng diagnosis is not merely a collection of symptoms, but reflects the location and stage of pathogenesis created by interaction between the stressor or pathogen and the body’s defense and regulatory systems. The diagnosis also aims to identify the global character of the conditions as either predominantly extreme or incomplete, yin or yang, hot or cold, interior or exterior.
The interaction of parasympathetic (yin) and sympathetic (yang) nervous systems can serve as a simplified example of yin-yang character in physiological processes. As a generalization, anxiety states can result from both excess of yang or deficiency of yin, but mixed excess-deficiency states are often observed. Since pattern diagnosis reflects the individual characteristics of the patient as they influence illness manifestation and progression, patients with the same Western diagnosis may present with different patterns. Likewise, patients with different Western diagnoses may present with the same pattern.
Once Dr. Robert makes a diagnosis, he will typically use acupuncture and herbal medicine together. As the treatment is applied, the practitioner monitors the changing manifestations of a pattern to assess success of the treatment and to adjust the strategy if needed. Herbal medicine, acupuncture and Qigong are used according to a two-level treatment approach: (1) to relieve the acute physical and psychological symptoms (e.g., insomnia, heart palpitations, acute anxiety, or gastrointestinal distress); and (2) to correct the patient’s unique underlying disharmony that has led to the somatic and psychological symptoms.

Joy, anger, anxiety, obsession, sorrow, fear and fright are the seven affects which are natural human responses to the environment. Chinese medicine regards the seven affects as capable of influencing the functions of the bowel and visceral organs. This is called, “internal damage by the seven affects,” or simply, affect damage.

Especially vulnerable is the free coursing function of the liver. Impairment of free coursing can lead not only to disturbance of qi dynamic, secretion, and discharge of bile but also to emotional disturbances such as depression, rashness impatience and irascibility.

The organs and channels are potentially damaged by excessive emotions but it is not a TCM concept that the emotions are stored or generated in or by organs. Further, these normal responses to the environment only become pathological when they are unrelieved. For this reason, when someone has suffered from emotional problems for a long time, there are often signs of heat, which may be in the liver, heart, lungs or kidneys.

In the seventy-seventh chapter of the Nei Jing Su Wen on “the Five Failings of Physicians” it is stated, “The fourth failing occurs in counseling. When a physician lacks compassion and sincerity, when a physician is hasty in counseling and does not make the effort to guide the mind and mood of the patient in a positive way, that physician has robbed the opportunity to achieve a cure. So much of an illness begins in the mind and the ability to persuade the patient to change the course of perception and feeling to aid in the healing process is the requirement of a good physician.” This is, in fact, the basis for TCM “dialogue therapy” which generally is initiated during the inquiry stage. Also, modern TCM, as it is taught in many schools in China, now incorporates both psychoanalytic and behavioral therapies.

Whether the table before me is real or illusory and whether it is only an idea in my mind or is occupying objective space was never seriously considered by Chinese philosophers. No such epistemological problems are to be found in Chinese philosophy (save in Buddhism which is from India, not China), since epistemological problems arise only when demarcation between subject and object is emphasized. And in the aesthetic continuum of Taoist, Confucian and other schools of Chinese philosophy, there is no such demarcation. In it these schools the knower and the known are one. This also explains why the language used in Chinese philosophy is suggestive and rather than articulate, because it does not represent concepts through deductive but rather abductive reasoning.

The philosopher only tells us what he sees and because of this, what he tells is rich in content through terse wording. This is the reason why his words are suggestive rather than precise.

Jade Dragon Tai Chi and Qigong…

Here on the Treasure Coast of Florida, in beautiful Vero Beach we are blessed with a number of practitioners and teachers of Qigong and Tai Chi Chuan.

This is regrettably not the case in every community and I am frequently asked by nonresident clients about how they too can enjoy the benefits of Chinese Internal Arts if there are no teachers nearby.

The first thing that comes to most people is to go online and find instruction on You Tube or other internet resources but there are some inherent problems with learning Qigong in this way.

The nature of Qigong in general is to raise the Yang Qi. Yang Qi is the motive or metabolic aspects of one’s “bio-energy”. Yang Qi is brought up in the body either by increasing the actual amount of Yang Qi with herbal medicines or by guiding Qi from the lower part of the body to the upper part.

This can lead to an overabundance of Yang Qi and the problem with an overabundance of Yang in the body is that Yang Qi is hot in nature and an excess of heat in the body can lead to headaches, dizziness, high blood pressure and a propensity to anger and aggression. This is especially problematic with the continued use of martial Qigongs.

A drawback to Qigong as a vehicle to spiritual cultivation is similar, the novice tends to become so enamored of the art that too much time is spent in practice and again an overabundance of Yang Qi causes the same excess heat symptoms of headache, dizziness and visual distortion.

The other problem with this type of practice is that it usually demands strict control of the breath. Whenever the natural breathing pattern is changed, the body’s entire physiology and psychology changes. Unless those changes are monitored closely by someone experienced in what changes can and should be expected and unless that person is able to intervene if the changes become pathological, there is the very real potential for permanent mental and physical damage.

The aforementioned problems can be greatly reduced or eliminated if the student is under the expert and watchful eye of a very experienced teacher.

Jade Dragon is the one system of Qi Going that I, as a physician and practitioner, can endorse for just about anybody regardless of his or her medical model. The system is so balanced that in the decades that I have been prescribing it to patients, I have never once had any negative feedback associated with it. It is also so easy to learn, that it is one of the few Qi Gong systems that can be taught via DVD. One to one instruction is best, and that goes for the Jade Dragon Qi Gong as well. But, the Jade Dragon DVD was developed by a doctor for his patients, and as such is quite unique in the realm Qi Gong DVD instruction.

The same is true of Jade Dragon Tai Chi, another component of the Jade Dragon family of internal martial arts. Both the Tai Chi and Qigong forms are available on the same DVD and were written and produced by myself. I make myself available for questions and critiques of your form via email or video and have had wide success with this manner of teaching.

The DVD and written manual are available for $40.00 which includes shipping and handling. I highly urge you to take advantage of this beautiful Qigong and Tai Chi system and I look forward to assisting in your learning experience.


Yours in Health,

Robert Kienitz, DTCM

With Offices Everywhere…

Although our physical office is located in Vero Beach Florida, we have many nonresident patients who rely on our services in a variety of ways.

People from as far away as California to the west and Europe to the east, take advantage of our superb diagnostic skills, dietary information and medical prescriptions.

Diagnosis in Traditional Chinese Medicine is based on the “four examinations”, these are; inquiry, looking, listening/smelling and touching. Of these, the last three were developed during a period of history when the majority of the population was medically illiterate and had difficulty understanding the signs and symptoms of disease or articulating that information to medical professionals.

Today, we still utilize the arts of looking, listening/smelling and touching but because modern people are medically literate (often more so than some of their healthcare providers), we are able to do most of our diagnostics through inquiry, that is, question and answer.

Dietary therapy at its simplest is to “eat a little bit of everything and not too much of anything” with the emphasis on “a little bit and not too much”.

For individuals with a particular physical complaint, we can prescribe foods that will enhance the healing process, retard the development of disease and regulate the digestive and immune system functions. We generally advise adding or omitting certain foods and keep to commonly available foods instead of prescribing esoteric and hard to find items like “Mongolian fish lips” or “fermented hens teeth”.

The majority of complaints that people have that are not musculoskeletal in nature (and even some of those), are remedied with prescription herbal medicines. Once we have arrived at a diagnosis, we can have the proper herbal medicine delivered to your door within one to three days. The nature of Traditional Chinese Medicine is that as people get healthier, their herbal medicine changes. We are able to make those changes seamlessly and continue uninterrupted herbal therapy as you progress to optimum health.

We look forward to your contacting us via email or phone and allowing us to help bring you to your highest and best.

Yours in good health,

Robert Kienitz, DTCM



What is Snoring?

Snoring is a common condition that affects over 40 million Americans as they sleep. Snoring is the result of obstructed airflow of breathing during sleep, and the wheezing, gurgling, and snorting noises that accompany snoring are made by the soft palate as air is forced through the oral and nasal cavity at high speeds. Snoring, while not a particularly serious condition itself is often associated with sleep disorders of a more potentially harmful nature, such as sleep apnea—a condition in which the sufferer stops breathing for up to 90 seconds. Other conditions and activities that may cause snoring are obesity, asthma, smoking, drinking alcohol, and eating a poor diet. If left untreated, snoring may create a greater risk of high blood pressure, heart disease, and stroke.

How can I treat Snoring?
Traditional Chinese medicine considers snoring to be the result of dampness. Living in Vero Beach on the Atlantic coast, we live and breath in an environment that is continually damp and that damp can lead to Qi (energy) stagnation. Treatment focuses on dispelling the dampness and unblocking the energy through a treatment plan that includes a wholesome diet rich in fiber and complex carbohydrates. Preferred foods for preventing snoring include quinoa, brown rice, yams, beets, carrots, spinach, broccoli, papaya, mangoes, citrus fruits such as limes and grapefruits, black mushrooms, ginger, and chrysanthemum flowers. Other remedies include gargling with warm salt water and drinking green and chamomile teas. Recommended exercise includes 30-minute walks, meditation and practicing Tai Chi or Qigong.

What should I avoid in my lifestyle for Snoring?

It is important to avoid foods that produce mucous and dampness, including cold and raw foods, oily and greasy foods, dairy products, white flour and sugar, soft drinks, wheat, chocolate, shellfish, potatoes, tomatoes, and eggplants. Other things to avoid are evening snacks, alcohol, antihistamines, stress, and lack of sleep. Perhapse the worst causitive factor I see among patients is cigarette smoking.

Green Tea and Snoring?

Many people assume that the “green” in green tea means herbal. The fact is that there is actually a tea plant, Camellia sinensis, which is related to the ornamental shrub known for its beautiful and fragrant flowers. Manuscripts in Asia harking back to 3000 B.C., relate the use of C. sinensis as a beverage plant. Its real popularity did not begin until around the second century A.D., and up until the 18th century all tea was green tea.

There are hundreds of distinct varieties of green tea and one can become as much a connoisseur of green tea as of fine wine (which also has medicinal value). The top producers of tea in the world are China, Japan and India. Depending on the region and elevation in which it is grown, the time of year it is harvested, it’s processing and environmental conditions such as rainfall and days of sun all combine to produce differences in flavor and quality.

The “green” of green tea indicates that it is processed to retain its fresh color. Black tea is usually dried and fermented which gives it the black color. Green tea is processed very little and the best types are processed by hand and either sun dried or pan fried. A great deal of art goes into the processing of green tea and shaping the leaves and the processing often contributes to the name given the tea. “Gunpowder tea” is rolled into tight balls resembling gunpowder pellets, “eyebrow” tea is shaped into crescents and “silver needle tea” is a thin rolled leaf with a silver color. The shaping and processing of tea also controls the release of flavor as the tea is brewed.

The beneficial properties of green tea are due to antioxidant polyphenols, researchers believe that drinking 4-5 cups of green tea a day may help reduce cholesterol and lower high blood pressure. In addition studies have shown that cardiovascular disease, blood sugar disorders and the body’s resistance to infection can all be helped by daily ingestion of green tea.

Caffeine content of tea is a concern to a lot of people but green tea contains 1/3 to 1/2 the caffeine of an equal amount of coffee. There is also growing evidence that the caffeine itself is not the responsible component of coffee jitters, rather it is the tannins in coffee that are virtually absent in green tea.

The Chinese and Japanese cultures have refined tea brewing into a high art that can take years to master, but if you want a cup quicker than that you can start with a cup (Glass or ceramic), of water that has been brought close but not quite to a boil. If there are tiny bubbles just forming from the heat, the water temperature is just right. Then take a small amount of green tea, 1/4 to 1/2 teaspoon should be about right, and gently drop the leaves right into the water. My Chinese teachers used to let the tea soak until it sank to the bottom of the cup, then the tea was done. My Japanese teachers, on the other hand, only let the tea steep for one to two minutes depending on the desired potency and then they dipped out the leaves. The length of brewing will obviously affect the taste and character of the tea so you have to experiment a little but the rule of thumb is longer steeping will produce more bitter tea.

Weather you try Japanese of Chinese styles of brewing, adding tea to your diet is considered by all to be highly beneficial to your overall health. Bottoms up!

Yours in Health,

Robert Kienitz, DTCM

Health for Body and Pocketbook

The other day I was standing in line at the local Vero Beach market and the man in front of me was purchasing cigarettes for he and his wife, one pack each. The cashier rung him up and said “that’ll be $12.73 please”. I was surprised, I had been vaguely aware that cigarette prices had been going up over time but, because I don’t smoke, I had no idea as to how expensive a habit it had become.

Setting aside the health implications for one minute we’ll do the math; twenty cigarettes a day (not an unusual amount for most smokers), for he and his wife, was costing them an average of $89.11 per week, $356.44 per month or $4,633.72 per year! Buying by the carton and switching to generic brands might drop that price by a few hundred dollars, but they are still looking at about four grand a year for the privilege of putting dangerous chemicals into their bodies that have been proven to cause diseases ranging from asthma to emphysema and cancer.

It took a great deal of personal effort to keep from accosting the man and telling him about the wonders of acupuncture and Chinese medicine for the treatment of addictions, especially nicotine. For years we have been using acupuncture and Chinese herbal medicine to successfully help people quit smoking without side negative effects.

Conventional Medicine Agrees

A recent study published in the medical journal Preventive Medicine showed the use of acupuncture for smoking addiction. This ambitious study followed 46 participants for five years. About half of the group was given acupuncture at points that corresponded to smoking. The other half of the group also received acupuncture but they were given treatment for their skeletal and muscular systems (so called “placebo” or “sham” acupuncture).

During the course of the study several people in the test group and in the control group quit smoking. The scientists studied the blood levels of smoking-related chemicals in both groups and found that the test group had less of these chemicals in their systems even if they continued to smoke after treatment.

The First Step

“Ya gotta wanna” quit. If you are not ready to stop smoking, you won’t. But if you do want to stop, acupuncture and Chinese herbs can help by reducing the desire for nicotine, clearing the free nicotine and other chemicals from your body quickly and calming the mind to make the process less stressful. Most people we treat quit within three sessions and those that fall off the wagon usually don’t take more than a session or two to get back on track

What Your Neighbors Say

“Over a period of two years, I have tried several programs to quit smoking. I have even tried to quit cold turkey without success. After one visit with Robert and Cindy Kienitz, I lost the desire to smoke. Wanting to quit was the first step, Acupuncture, and Breath-work sealed the deal. I have not felt the need to smoke since.”

Sebastian, FL

“I went to see Dr. Robert for help with stopping smoking and was so amazed with the results that I’ve sent half the population of Orchid Island to see him. Keep up the great work Doc!”


Orchid Island, FL

Even if you don’t smoke (good for you!), you probably know someone who does. Pass this information on to them and help them save their lives while also saving money.

Yours in good health,

Robert Kienitz, DTCM

Eight Tips to Beat the Heat

Here in Vero Beach Florida, the summer heat can sneak up on you and not only zap your energy, while you are outdoors, but it can cause dehydration, sunburn and actual exhaustion! Children under four, people over 65, and those who are obese, already ill, or taking medications can especially be affected very easily. Prolonged exposure to heat and insufficient body fluid can result in heat exhaustion. Its symptoms can include heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness headache and nausea or vomiting. Here are the best remedies for heat exhaustion:

  1. Carry water with you and sip it throughout the day. Dehydration can set in and we don’t even realize it until we begin to feel thirsty!
  2. Pace yourself when working outdoors, exercising or just having fun. Those who participate in regular exercise over time, allowing their bodies to adjust to hot conditions, may better tolerate exercise on hot days.
  3. Replace salts and minerals with electrolytes such as Gatorade or other power drinks that have potassium. Avoid drinks with large amounts of sugar. Dehydration can stress the heart and impair the kidneys’ ability to maintain the correct level of fluids and balance of electrolyte. Electrolytes are charged elements—like potassium, sodium, phosphorous and chloride—essential for the normal function of every cell in the body.
  4. Wear lightweight clothing the lighter the colored clothing (white, being ideal) the more sunlight is reflected away from you. Darker colors absorb the light and heat.
  5. Seek air conditioning, cool breezes under the shade and/or take cool showers in order to bring down your body temperature.
  6. Sunburn can happen very easily if you are not careful. Dilute one part Tea Tree Oil with ten parts of olive oil or coconut oil and spread freely over the affected areas. This is soothing and pain-relieving and to reduce blistering and peeling. People have also applied tea tree oil full strength to sunburn.
  7. If you feel dizzy and/or stop sweating, quit all activity and get out of the sun fast. Drink cool, not cold water with a teaspoon of apple cider vinegar in it. The vinegar helps to replace electrolytes and minerals like sports drinks do.
  8. In ancient Egypt, China and the Far East, watermelon juice and its seeds were traditionally offered to thirsty travelers, and they are still important today in times of drought or water pollution. This flavorful fruit is one of the best remedies for dehydration and summer heat symptoms, which include thirst without desire to drink, band-like headache, nausea, low appetite, heavy, weighted body sensation, low motivation, sluggish digestion, increased body temperature, sticky sweat, surging pulse, and red tongue with thick white or yellow coating. Watermelon cools and cleanses the system, clearing summer heat and acts as a natural diuretic.

Yours in good health,

Robert Kienitz, D.Ac.

Summer Heat Syndrome

On these hot and humid summer days in Vero Beach, nothing beats a nice cool glass of water! Most of us know that we need to stay hydrated, especially when we are working outdoors during the heat of the day. What a lot of people are not aware of is, that drinking a lot of water is good but water can push electrolytes out of our systems through perspiration and urination. Deficient electrolytes in our bodies can result in fatigue, cramping, nausea, dizziness, irregular heartbeat and eventually convulsions and coma. In Traditional Chinese Medicine these symptoms all fall under the disease category of Summer Heat Syndrome.

Electrolyte is a “medical/scientific” term for salts, specifically ions. Electrolytes are important because they are what your cells (especially nerve, heart, muscle) use to maintain voltages across their cell membranes and to carry electrical impulses (nerve impulses, muscle contractions) across themselves and to other cells. Your kidneys work to keep the electrolyte concentrations in your blood constant despite changes in your body. When you excercise heavily, you lose electrolytes through perspiration and drinking plain water, though refreshing, does not replace them. The major electrolytes in your body are: sodium, potassium, chloride, calcium, magnesium, bicarbonate, phosphate and sulfate.

These electrolytes must be replaced to keep the electrolyte concentrations of your body fluids constant. So, many sports drinks have sodium chloride or potassium chloride added to them. They also have sugar and flavorings to provide your body with extra energy and to make the drink taste better but many people find sports drinks too sugary and instead use the various forms of Pedialyte. Another alternative to sports drinks and Pedialyte are electrolyte replacement packets that you can find in camping supply or army surplus stores. One electrolyte replacements found in most drug stores is “Emergen-C”.

The traditional Chinese approach to Summer Heat Syndrome is simple, tasty and good for you. Rich in electrolytes, fiber and refreshing goodness. Watermelon (xi gua) is the first choice of Chinese herbal medicine to treat and prevent Summer Heat Syndrome.

Whatever your choice of electrolyte replenishment, be sure to recharge every day and more often if you are engaged in outdoor activities of any kind.

Yours in Good Health,

Robert Kienitz, DTCM

Acupuncture Measurements . . . Location, Location, Location.

A question I am frequently asked is “how do you find the hundreds of acupuncture points on the body?”

In the Compendium of Acupuncture and Moxabustion it was written “Methods of locating points are based on standard measurements. An acupuncturist must have a clear understanding of these measurements, the patients build and a mastery of the anatomical landmarks of the body”.

The three main factors involved in point location are: proportional measurements, anatomical land marks and finger measurement.

Proportional measurement has the widths or lengths of the various parts of the human body divided into standardized numbers of equal units of proportion. These standards are applicable to any patient regardless of age, sex, width or height.

Anatomical Triangulation is the use of anatomical landmarks for point location. There are two types of landmarks, the first are fixed landmarks that include sense organs, hair, navel and the prominences and depressions of bones. For instance the point at the tip of the nose is Suliao or Du 20, the point at the center of the navel is Shenque or Ren 8.

Photo of Flexed Arm  showing Quchi or Large Intestine 11 acupuncture point.
Flexed arm showing Quchi or Large Intestine 11 acupuncture point.

The second uses of anatomical landmarks are moveable or require movement to find. To locate Quchi or Large Intestine 11, the arm is flexed and a crease appears at the bend of the elbow, the point is at the outer part of the crease on the outside. When the palm is flat and the thumb and forefinger are held together there is a bump of flesh between them, the apex of that lump is Hegu, Large Intestine 4.

Finger measurement; the width of the first joint of the thumb is referred to as 1 cun (pronounced tsun). This is the standard measurement used in both proportional measurement and anatomical triangulation. The distance from the center of the knee to the tip of the outside ankle bone is 16 cun, the distance between the inside crease of the elbow to the wrist is 12 cun.

Using these measurements we can locate points using references like; the acupoint Neiguan, Pericardium 6 is located 2 cun above the wrist crease between the two tendons.

There are many shortcuts we learn to find the hundreds of acupuncture points in TCM College but the bottom line is that to be an effective acupuncturist it is all about location, location, location.

Yours in good health,

Robert Kienitz, DTCM