Background on Duality & Complementarity

Asian, and other traditional systems of medicine that developed in close harmony with nature, speak of an underlying duality, an implicit complementarity that permeates all natural systems.  Quantum mechanics, more specifically quantum electrodynamics (QED), has also found similar intertwined and inseparable complementarities in the physical world, at a deep level.  This precept apparently got lost in Western societies during the European Renaissance, due to the compromises that the French polymath Rene Descartes, and other anatomists, had to make with the Church, to continue their studies of the human body.

Natural limit stops are seen in all engineered systems, at both the low and high end of the range of responses to inputs (stimuli). If we are willing to consider that our bodies, the most complex engineered systems on this planet, share these attributes, we can understand both the etiology of the intense feelings, i.e., sensory overload, video feeds (news), and the associated responses, i.e., cognitive dysfunction, we can experience at times.

Contrary to the conventional medicine and psychiatry practiced by medical doctors, integrative Asian models of Being link the organs in our torso to our emotional states, not just the brain.  Along these lines, there is increasing interest in our autonomic nervous system, and its roles in precipitating hard to treat conditions affecting both Body and Mind.  In my opinion, our cerebrum provides “remote integrative” and selective filtering functions, associated with incoming sensations and stimuli.

Mess with important organ (e.g., Zang) functions, and the organism level damages will accumulate and come knocking as we age, e.g., metabolic disorders, increased frailty, cognitive impairments.

 

Shi (Excess) Patterns 
In the TCM lexicon, internal excess patterns generally have a Yang aspect, often bordering on crisis and collapse. Though internal excess Yin pathogenic influences are recognized, as in Damp – suboptimal accumulation and retention of body fluids, my research suggests that these patterns must be treated as an adaptive response to unrelenting work, and sometimes home, based stressors.
Our human resource (HR) specialists can testify about how their services exploit workers on behalf of the employer, leading to widespread work place Disharmony, as noted by widespread employee behaviors like absenteeism and ghosting, in this post Covid era.

Our focus here is on the Internal Excess Yang (IEY) patterns, on how they are fraying the psyche – society interfaces of our communities, and on the damage they are doing to the stability of the social contract. As noted earlier, chronic sensory overload can become a form of torture which some of us are unable to turn off.

 

Which organ networks are affected?
The Zang organ networks most likely to show Shi patterns in Western societies are the Liver and the Heart. The Liver (Wood) serves in a generative capacity to the Heart (Fire).

In the Liver, early stage Shi patterns can manifest as labored breathing and sighing, suggestive of weak engagement of the abdominothoracic pump, a key motive aspect of our respiratory system. This understanding was rediscovered by clinicians battling Covid in Spring 2020.
As the General, an anthropomorphic reference to this organ-networks’ diverse biochemical and physiological control functions, it does not tolerate denial.  As the Disharmony (pathology) progresses, we see chronic irritability, uncontrollable outbursts of anger, and GI (Spleen) related responses like free- floating anxiety, heartburn, constipation, diarrhea.

When all systems are working together, to support the General, the positive and celebrated emotion manifested by the Liver is benevolence, as encapsulated in the phrase de oppresso liber.  On the dark side, in states of Disharmony, the emotional energy that comes out is Anger, and violence, when our emotions get bottled up.  Support your own General, get some exercise.

TCM medical theory link many of these outbursts to Fear, the emotion linked to a troubled or dysfunctional Kidney  network.  The Kidney (Water) network, which extends into the HPA axis, serves in a generative relationship with the Liver (Wood).
Research on the prefrontal regions of our brains have linked many of the patterns seen in spontaneous community violence, whether perpetrated by the police or by the public, as driven by  chronic Fear activation, aka dysregulated Threat perception. Other brain regions involved in these reactive scenarios  include circuits within the amygdala, the hippocampus, and the limbic system.

A key precept from this community is that many chronic mental health issues – like stress, anxiety, and depression represent cognitive level expressions of long term unresolved systemic inflammation and reduced neural plasticity, i.e., reduced capacity for adaptive and resilient responses to the daily/regular societal stressors seen in fast moving industrial societies. Experimental (clinical) conditioning studies show that these responses can be precipitated in all  of us by repeated insults and injuries, including microaggressions.

The current life trajectories of Native Americans and African Americans reflect centuries’ long patterns of continual harassment, denigration, land appropriation, and outright planned murder, first by our three branches of our government, then by the Media, and followed by the public at large.  These actions have not gone unnoticed.  The invocations of the Ghost Dance have been activated.

 

In the Heart, Shi patterns are recognized by Mania, a condition manifest by periods of great excitement or euphoria and extended overactivity, sometimes with delusions. Delusions are a sign commonly seen even in “normal” people when sleep patterns become dysfunctional for extended periods.
This period is often followed by a metabolic crash, with attendant cognitive level symptoms (Depression). Current research links developing Bipolar type patterns with even more serious genetically linked conditions like schizophrenia.   The intergenerational transfer of these illnesses in oppressed communities are linked to epigenetic processes, also known as social weathering.

Humanitarian psychiatry has recognized that countries like India and Africa, with their more open, inclusive, and less status conscious societal perspectives, may be more supportive and offer alternatives for both managing and resolving these IEY types of health issues.
Initiatives like Portland Street Response, a program within Portland Fire & Rescue, are taking the correct approach to managing the widespread emotional crises in our metropolitan centers.  It is important to realize that all emotional crises have an underlying relationship component.

In this regard, I remind parents who bring their children in for “concerning behavior patterns”, a diagnosis by a psychology specialist is preferred to a generalists’ (e.g., PCP) opinion.  This is because diagnoses based on DSM-5, the current diagnostic guidebook for mental health disorders, are statistically supported OPINIONS of SOME specialists.

Pain & Suffering … Yin & Yang Aspects
In diagnosing a patient who is  experiencing chronic pain, e.g., low back pain (LBP), it is important that I work with information from prior professional diagnostic workups.  It takes multiple acupuncture sessions to build rapport with the patient and understand their perspectives on their primary health concerns, before we can unravel the prior clinician confusion.
A 10 minute evaluation visit and prescription session for pain management can fail to recognize that the LBP, or other unresolved pain syndromes, were actually epiphenomena associated with deeper cognitive disturbances, most often stress, anxiety, and depression, in our country.

Even in wealthier communities, chronic spousal stress often manifests as anxiety, which can then precipitate or reactivate chronic pain and muscle tension patterns or other physical signs and symptoms that don’t show signs on  radiologic evaluations.
Then, we have the plight of K-12 educators in Oregon, who apparently have to control food and fluid intakes for extended periods, because they cannot take a restroom break for many hours at a time.  I thought there were employment laws to prevent this type of worker abuse. They apparently are not working for these K-12 educator communities.

Prescribed Drug & Medical Procedure Induced Cognitive Dysfunction
Both prescribed drugs and some invasive surgical procedures are also known to cause Shi patterns of Disharmony, e.g., delirium.  As doctoral level pharmacists (PharmD) note, medical doctor didactics on drug metabolism (ADME) and adverse drug-drug interactions is apparently limited to about a year. Other clinicians who diagnose and prescribe may have even less training.  For those of us who look at the world from a molecular perspective, this is an expanding American sickcare tragedy that has not yet peaked.

For these reasons, identifying the etiology precisely, e.g., drug induced liver injury affecting cognitive processes, is important to resolving these widespread manifestations of chronic threat perception, followed by violent outbursts.
We  know the structural changes that are  needed to fix these problems, but they have not yet gotten adequate HHS attention and fiscal support.

 

To err is human
In my practice, all conventional medicine diagnoses are open to reappraisal, especially if I identify the problem, i.e., the root cause, as discordant with prior diagnoses. These issues are often associated with signs and symptoms that clinicians who diagnose and prescribe may not have understood correctly. These misdiagnoses may occur because, in cases of pain, clinicians do not often conduct palpatory evaluations to identify and circumscribe pain affected areas, leading to relatively empty but billable diagnostic references like “compartment syndrome”, at the ED.

When I find substantial errors, as in unrecognized adverse drug-drug interactions, I usually advise my client (patient) to share my thoughts with their care team, especially if they are on psychotropic medications.  We continue to work together till there is enough data to support changes in drug therapeutics, by the prescriber.

 

How can we resolve Shi patterns?
The lowest cost scalable model of care that I know of, for chronic mental health disorders, an approach that is also known to lead to  increased social benefits, i.e., more social interactions, involves the reinforcement of Body awareness using physical activity routines with more integrative aspects than conventional PT.
I favor Body & Mind integrative movement therapies, with thousands of years of practice and evidence, from Asia.  However, there are cultural- educational barriers in status quo adherent and high status conscious communities like Wilsonville, with a limited appreciation for new perspectives, e.g., the use of the scientific method for solving chronic health concerns.

 In our age of monolithic ethnocentrism, a clear and widespread societal marker of lower cultural diversity, we throw psychotropic drugs at chronic mental health issues and wonder why things are not working out so well, culturally.
One of the greatest blunders of American healthcare’s handling of mental (behavioral) health issues, and an unrequited fantasy of medical doctors, is that human beings can be treated as “isolated” behavioral units, i.e., systems that can be  “engineered”  to behave appropriately using synthetic psycho-pharmaceuticals.

This position is not supported by science. We have been transformed over the last few decades into a drug dependent nation, at the hands of clinicians who carelessly prescribe powerful psychotropic drugs. Dependency producing drugs like narcotics and antidepressants are being used to address cultural factors like chronic stress in marginalized communities, without recognizing their downstream physiological  and psychological consequences. In addition to stress, these cohorts risk developing substance use disorders.

More disciplined and enlightened people, ~1-5% of the American population today, are beginning to recognize that this “drug swallow” enteral model of care is not working for tens of millions of people. They are willing to invest in the long term personal effort to improve both mental and physical health, with a self directed. integrative focus. They have started on the journey to recognize the healer within, a process (path) that has been used and studied for thousands of years in Asia. No drugs needed, just a personal long term commitment to learning about one’s body.

In these situations, therapeutic exercise become a part of ongoing discussions of physical medicine options, during acupuncture and TuiNa sessions in my clinic. As my patients become stronger and can achieve full range of movement (ROM), under load, it is time to discuss advanced chi kung  and yoga techniques that can be used safely by elder and frail populations, if they are not experiencing cognitive impairments.  However, other communal activity options are available, as noted below.
I learn from and support any therapeutic movement form that works, e.g., calisthenics, dancing, walking, stretching, swimming, and/or a combination of the above.

The foundational idea is to build increased Body awareness, as I have noted earlier. Return the excess Yang energy to its proper home, to do what it was intended to do, to protect and power the human body (Yin).

The fun stuff in exercise… breaking stagnation/constraint patterns, sweating or internal cleansing of the skin, loud vocalizations, feeling warm all over without pain, feeling confident, and connected from head to toe. Examples?

How does that Limbo Rock (lower the bar) song go…

Dance – a 21^st century Moving Integration.
Make it happen in your community.  Be Well.