My professor of Traditional Chinese Medicine (TCM) was new to the United States, having recently arrived from mainland China. Like many of my professors he was (and is) a brilliant clinician who combined a comprehensive knowledge of TCM with the kind of direct, no-nonsense empathy that resonated with the people seeking low-cost treatments at our student/faculty clinic. One day, after several hours of treating back-to-back patients, he looked up from his chart notes and sighed: “why does everyone here have the same pattern?”
In TCM, we don’t talk about a diagnosis the way that conventional Western medicine does. Where part of Western medicine’s brilliance comes from a reductive scientific method that filters out irrelevant information to arrive at a single diagnosis, TCM works in the opposite way. We want to know everything that is going on with a person -- their digestion, sleep, energy levels, mood -- and all of these things fit together to create a pattern of disharmony. Ultimately, what we are treating is the pattern of disharmony, not just the individual symptom that brought them into the office. In other words, three people might come in, each looking for help with migraine headaches, but each will receive a unique treatment according to their own pattern.
What my professor noticed that day was that a huge percentage of the Americans who came into our clinic were all presenting with the same pattern: liver-spleen disharmony. I should emphasise that this does not mean that anything was structurally wrong with their livers and spleens. The issue lay in the functions that TCM attributed to those organs. For instance, according to TCM, the liver is in charge of the free flow of Qi, the energy that moves through your body along channels. When you are healthy, the Qi moves freely. When you are in pain, sick, or emotionally upset, the Qi can become stuck. The spleen is largely responsible for the transformation of food into energy and when the liver Qi is stagnant, it can impact the spleen’s ability to transform food effectively. Once the body isn’t transforming food effectively, it means there is less energy to flow throughout the body, which then means energy gets even more stuck. In other words, the dysfunctioning of these two organs becomes a negative feedback loop, each worsening the other. This pattern can manifest as headaches and other pain, abdominal bloating, chronic fatigue, menstrual difficulties, depression -- and more.
In the 20 years since my professor scratched his head with this observation, my own clinical experience still holds it to be true. Both in the United States and here in the United Kingdom, liver-spleen disharmony is easily the most common pattern I see with patients. As a lifelong resident of the Western world, however, I am not surprised by its prevalence. In my experience, this pattern is about five things:
Stress. When we are stressed, the Qi becomes stuck and you may express this stagnation by clenching your jaw, stopping breathing, or tensing your shoulders. Both the UK and USA value achievement and material success, competition, and striving, but this can have serious consequences for our health.
Shoulds. We are fluent in the “shoulds” and “shouldn’ts” -- I should be working right now, I shouldn’t be on the computer as much, I should exercise more, I shouldn’t be feeling this feeling, I should have accomplished more by now -- we are so busy corralling our existence that the energy of the body stagnates.
Emotions. In TCM, we believe that emotions come and go like water in a stream. If we let them come and express them, everything should be fine. However, sometimes we deny or "stuff" challenging emotions, such as anger, sadness, grief, or jealousy -- or, conversely, even feel we shouldn’t show too much joy!
Exercise. If we aren't physically moving, Qi is less likely to move. Here in the UK, we tend to move our bodies more than in the car-centric American society and this serves our energy better, but there could still be room for improvement.
Food. Again, the spleen is largely attributed to the transformation of food into energy. Some foods, such as soup and lightly cooked vegetables, are easy to transform. Other foods, such as dairy, sugars, raw or cold foods, and fried foods, are difficult to transform. If your diet consists of more of the latter, especially if it is washed down with too much alcohol, you have a digestive system that is already suffering from the load.
Does any of that look familiar? I would offer that the “Western way” often encourages stress, overworking, emotion-stuffing, screen-watching, and food-as-stomach-filler. Even when we try to avoid these things, it is easy to feel pulled in a number of directions in our daily lives and usually our self-care is the first to go.
So what do we do? Acupuncture is phenomenal in the treatment of this particular pattern and, if a person is open to it, I could also prescribe traditional Chinese herbs. What happens when the person is not in the clinic, however, is even more instrumental to how their bodies and minds will heal:
Create and Play. A great way to counter the “shoulds” is to do something that requires you to freely say “yes” to your inner impulses. Paint, sing, join an improv group, or play a silly game with rules that you make up as you go along. Make friends with yourself and have fun.
Meditate or find another way to manage your stress. Long baths, mindfulness, and writing in a journal are all great -- as is talking to a friend or doing something else that you enjoy. As you read these words, you probably already know something that might help you feel better -- trust that.
Feel. Know that your feelings are right, and they are temporary. If you feel you need help processing your emotions, please consider seeing a therapist to help you.
Move. It doesn't have to be high-intensity interval training and, in fact, exercise that is too intense may further deplete your Qi. Any time you move your body in a way that you enjoy, with some vigor, that is good. Tai chi and qi gong are wonderful, gentle ways to get your Qi moving without taxing it too heavily. Or just turn on the radio and dance to a few songs.
Savor. Experience and enjoy your food. Experiment. Slow down. Smell it. Taste it. Eat only enough to feel 70 percent full. Accompany your meal with warm or room temperature water or tea.
Don’t feel as though you need to make all of these shifts at once. Making a gentle shift in one area will have positive repercussions throughout your entire system. Start with the one change that feels easy or fun and keep doing it until it becomes your newest habit -- and eventually, you will be able to shift the pattern that affects so many.