Tag Archives: Oriental medicine

Placebo and Qi

An article in the September 3-9, 2018 issue of Time magazine, “Placebo’s New Power,” describes instances of people knowingly taking placebos and getting relief.  These “honest placebos” were administered in a study of irritable bowel syndrome (IBS) patients.  One patient, whose IBS symptoms improved dramatically during the study, later found her symptoms recurred.  She decided to continue the placebo treatments at the researcher’s private clinic and achieved remission again.

Overall, results were so encouraging in this Beth Israel Deaconess Medical Center study that the National Institute of Health has awarded the research team a $2.5 million grant to replicate the study.

Placebos have been around since time immemorial, used to advantage in numerous conditions.  Their use is predicated on the belief that a patient’s faith in the treatment has a healing effect.  Formal pharmaceutical studies in Western medicine measure a presumed new drug’s effects against placebo to determine whether it will work on a large scale.  In Western medicine, generally, the “placebo effect” is disparaged, as though there is something “un-scientific” about it.

The Time article speculates about why people who know they are taking fake pills get better.  It notes patients appreciate doctors who validate their suffering.  They fare better with doctors they perceive as warm and competent.  We are told that confidence in “medical industry leaders” in the US has plunged to 34%, from 73% in 1966.

To me, this is another example of Western medicine taking credit for applying common sense.  Not once does the article mention such old-fashioned terms as “bedside manner,” which cannot be measured or billed for in the codified, prioritized list of “evidence-based” protocols that wants to squeeze patients into convenient, binary-based boxes.

In Western medicine, the patient is seen as a relatively passive recipient of medical care.  The doctor, treatments, and pills act upon the patient, with the external agent believed to effect the healing.

In contrast, Oriental medicine perceives the body is its own healing agent, with its own homeostatic wisdom, presumed to want healing, with the practitioner a partner and participant in the process.  Belief in the treatment, and in the practitioner’s competence, are valuable and acknowledged aids in the healing process.  Far from being “placebo,” the partnership between patient and clinician becomes an integral component of the treatment goal.

A fundamental difference between Oriental and Western medicine involves “qi,” (also spelled “chi”) or “life force.” In Oriental philosophy and medicine, “qi” pervades all things, and is crucial to life. When the body’s “qi” is depleted, restricted, or out of balance, it leads to trouble.  Disharmonies begin on a spiritual level, then become increasingly “dense,” manifesting as intellectual, emotional, and finally physical levels.  Practices like acupuncture rely on stimulating or balancing qi along specific energy channels called “meridians.”

There’s a mistaken belief in the West that we know more than we do about the body.  While we point to specific brain chemicals, such as neurotransmitters serotonin or acetylcholine, these are only two of perhaps thousands of brain messengers that interact in a constant dynamic.  The brain is only one organ in an equally complex body, with signals going back and forth at lightning-fast speed.  Western science presumes the body is like a machine, but the mechanical construct of Western medicine gives no credit to life.

For me to say Western medicine is backwards, that the practice of dehumanizing patients under mechanical models works against health, may sound extreme.  Certainly the most expensive “health care industry” in the world deserves more respect, more funding, and more of our life blood.  But I suspect the opposite, that the commercialization and institutionalization of the “health care industry” has devitalized the system in the name of high-tech, low-yield placebos that only help if you believe they work, and often not even then.

 

The Power of Life

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May 28, 2017—The following thoughts give an overview of my reasons for skepticism about Western, allopathic medicine and the paradigm it represents.  I claim the overriding belief in external agents for healing or symptomatic relief ignores the basic dignity of the individuals in question and the “vitality” that keeps us going.

The body is a marvelous homeostatic instrument, for which health is the natural state.  This understanding pervades Oriental medicine, which is based on the concept of “qi” (“chi”) or life force.

I’m an amateur student of Oriental medicine so can only describe it in general, simplified terms.  Essentially, it holds that there is a continuum between spiritual, mental, emotional, and physical levels.  Problems begin as spiritual.  If not resolved at that level, the problems become increasingly “dense” until they show up in the physical body.

In Chinese medicine, the idea of qi underlies and informs the entire system.  This sets Oriental medicine at odds with the Western, mechanistic viewpoint we Occidentals take for granted.  With the advent of the industrial age, the “scientific method,” and the requirement for “objectively verifiable” evidence, we’ve come to rely on instrumentation and a cause-and-effect sequence for assessment and treatment of any given condition.  The body is treated as though it’s a machine, with the resident human being largely a passive recipient of the diagnoses and treatments decided by the technician/physicians who administer them.

While the official stance of “science” receives almost religious devotion and some legitimate respect, it is exceedingly limited in what it can do.  “Science,” which relies on measurable “proof” has yet to prove that life exists.  Nor has it located the “mind,” although most believe the “mind” is in the brain.  The scientific method relies on studies that theorize causes, then set up conditions that limit variables to one, to determine whether there’s a significant correlation between cause and effect.

My unorthodox approach to life, health, and medicine stems from a fundamental belief in the power of the life force.  I call it “vitality,” but others may refer to “qi,” “quality of life” or use any number of terms to describe this battery that keeps us going.

Whether individuals survive physical death, and if so, in what capacity, is a question no one can answer, although religions and philosophers of all persuasions have tried.  What is life, anyway?  Is it a candle flame that can be extinguished?  Is it an essence, like “qi” that joins the “qi” of the cosmos, to be re-born in another place and time?

I won’t try to answer these questions but raise them simply to note that a belief in life beyond death strongly influences how I live mine.  Certainly others wrestle with the question, especially as they get older and wonder what lies ahead.

I became a psychiatrist partly to help make philosophy practical, but the profession—and Western medicine as a whole–is going in the opposite direction.

“How so?” a reasonable person may ask.  The most obvious answer is that it devalues the most basic principles that keep us healthy or make us sick.  Western medicine systematically undermines the individual’s faith in his or her own body’s self-correcting mechanisms.  It pits mind against body, which is deemed untrustworthy, a thing to be feared, unreliable.

The intangibles that formerly distinguished psychiatry from other medical specialties, the “quality of life” issues—now take a back seat to “evidence-based medicine” and the vain attempt of psychiatrists to align with the more “scientific” practitioners.

The antidepressant Prozac (fluoxetine) was introduced in 1989, two years before I graduated from medical school.  This began the separation of psychotherapy and other “talk therapy” from “medical management” of emotional problems.  While other antidepressants, anti-psychotics, anti-anxiety agents, and mood stabilizers had been on the market for decades, Prozac began the trend toward a raft of new, patented, drugs that could treat symptoms while ignoring the larger life pattern that led to the problems.  “Talk therapy” was shifted to psychologists and social workers, with the move heavily supported by government and insurance reimbursement criteria.

Since that time, the avalanche of patented drugs, technologies, diagnostic tests, and other interventions has made the “health care industry” one of the most profitable sectors in the United States.  Costs for the individual have skyrocketed, such that few can afford medical help without insurance.  Now, the government has made insurance mandatory.  No one seems to recognize that insurance does not equal health care.  In fact, insurance impedes, rations, and delays health care, and it raises the price for everyone.

Medical care costs twice as much in the US as anywhere else.  Medications are significantly more expensive.  A continuing medical education article I read says medical error is now the third leading cause of death in the US, after cardiovascular events and cancer.

That medicine and psychiatry seem obsessed with finding or creating problems already puts patients at a disadvantage, in a defensive position.  Psychiatrists don’t get reimbursed for “no diagnosis.” They must find or invent a diagnosis, a label, to justify the time they spend.

No wonder Oriental medicine has such appeal for me.  Here, diagnosis is based on patterns of disharmony within the body and mind.  The hands-on approach is individualized and personal.  The patients and the practitioners are partners, with the belief in the treatment’s effectiveness–“the placebo effect” in Western terms—a desirable component.  In short, it respects the dignity of the vital forces that medicine presumes to reinforce.

I hear people say that “health care is a right.”  We also have a right to refuse health care, especially when it’s forced on us by hostile, predatory forces.  We have the right to eat nutritious foods, life a balanced life, and keep stress levels low.  We have the right to maintain our vitality and health they best way we know and to choose who and what to trust for help when we need it.

 

The Mind-Body Connection

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From “The Foot Book: Healing the Body Through Reflexology,” by Devaki Berkson, 1977

Anyone who has a neck has a mind-body connection, assuming the mind is in the brain, which has not been proven.  In fact, with the medical mucky-mucks pontificating about “evidence-based” medicine, I have to ask what evidence do we have that the mind exists at all?  In fact, what evidence do we have that life exists?  We can’t measure either of these on our fancy instruments.

Albert Einstein, who sought in vain for a unified field theory to link the different universal forces, like gravity, and strong and weak nuclear forces, took life for granted, as Western medicine and science do.  Oriental philosophy does somewhat better, with its acceptance of “qi” or “chi,” loosely translated as “life force.”  Philosophically, I prefer the Oriental paradigm, which assumes a living cosmos, emanating from the inside out, like a holograph.  Embryos grow from the inside out, as do plants from seeds.

While people know the brain is in the head, they forget that nerves extend from the brain to almost every cell in the body, in a feedback loop that transmits information and directions back and forth with dazzling complexity.   Chemical messengers and neurotransmitters number in the thousands.   Only a few have been studied, and even these are poorly understood.

The so-called “scientific method,” a construct of the mechanized Western model, assumes cause and effect, yet it requires limiting any “scientific study” to one variable. This creates an artificial situation which attempts to control for confounding factors and leads to skewed results.  Alternatively, the Oriental model, which sees disease, for instance, as a pattern of dis-harmonies, is inclusive.  It presumes there are no single causes and that dis-harmonies create patterns of dis-equilibrium. Disciplines like acupuncture strive to re-balance “qi” to improve health and quality of life.

Ear acupuncture and reflexology are based on the idea that there are correspondences between points on the ears, hands, and feet and the various organs and structures in the body.

earacu

Acupuncture does not lend itself to the “scientific method.”  Because it is holistic, it cannot be reduced to “cause and effect” studies.  Also, studies into acupuncture can’t be double-blinded, as the acupuncturist presumably knows which points are the “real ones.”

However, as East and West develop more ties, acupuncture is receiving more attention and acceptance, especially for such conditions as pain and substance abuse.

Reflexology, which is a specific form of massage, does not get as much attention, but it has the advantage that anyone can do it.  I make no claims about its healing properties, but I can vouch for the fact that foot and hand massage feel good and constitute a safe form of touching in a skin-starved society.