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.

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