Not Guilty!

In Traditional Chinese Medicine disturbances in our emotional life are considered to be a major cause of illness. If healthy emotions are ones which are appropriate to the situation we are in, an unhealthy response is one that is not so appropriate, either excessive, inadequate, or just not fitting. Such responses if they are ongoing or habitual lead to illness.

So, for example, there are situations where it is healthy and appropriate to be angry, but if our anger is out of all proportion to the situation, or we are always angry and always on the edge of losing our temper, then not only will this be distressing to those around us, and to ourself, but also it will over time make us ill.

Traditionally, emotions which can cause problems by becoming excessive or ingrained are anger, sadness and grief, fear, excitement and pensiveness. But what about something like guilt? Guilt plays a significant role in the lives of many people, but is not mentioned in traditional lists.

What, anyway, is guilt, and how might it be a factor in our health? We might suspect that in the modern world there is some confusion about this, as ideas about what is right and wrong have changed considerably in a relatively short space of time. Guilt is a feeling we have when we have done something wrong, or rather when we have done something that we consider to be wrong. Of course, this may equally apply to something that we have not done but feel we ought to have done. Perhaps we feel remorseful, that we have let ourselves and others down. But on the other hand, it is noticeable that quite a few people seem to feel guilty when they do not seem to have done anything to be guilty about.

Some people, for instance, feel guilty if they have a rest. They feel that they ought to be doing something, almost as if they can only justify their very existence by being useful. They may drive themselves into the ground, always working and busy and useful, to the detriment of their overall health, simply because they would feel guilty if they stopped. Of course this can be a convenient failing for others – family members, co-workers or bosses – who may come to rely on the guilty person’s addiction to work and usefulness.

It is important for such a person to realise that they are being driven by this irrational guilt; it is important to acknowledge that it is not healthy, not a good thing. This might be difficult, because  it may look, both to the individual themselves and to others (especially ones with a vested interest), as if they are making a valuable contribution by being so busy.

Such a person may in fact need to learn to waste time, as shocking as that may sound! They need to learn that they do not need to justify themselves by being busy, and they may also need to learn to say ‘no’, sometimes, to family members, co-workers and bosses.

Acupuncture treatment is a good first step for such a person, if for no other reason than it involves them spending an hour or so of their time not being busy (and 20 minutes or more of that time lying down to boot!). But beyond that,  acupuncture can work at a deeper level of the psyche, helping  them  perhaps to  realise that they do not have to justify themselves by work and busy-ness, and that they need not feel guilty if, from time to time, they have periods of uselessness!

When Does Dedication Become Obsession?

In Traditional Chinese Medicine, health is seen very much in terms of harmony and balance. So it should be clear that obsession, which is virtually by definition a state of imbalance, is an unhealthy place to be. Obsessional behaviour is of course quite common; the term ‘OCD’ has entered the language, and many people will describe themselves as having some obsessional traits, ranging from mild idiosyncrasies to full blown mental health problems.

But is obsession always bad? Is balance always such a good thing? Suppose you want to achieve, and not in a mediocre kind of way; perhaps you want to be an elite athlete, even an Olympic champion. Perhaps you want to be a millionaire. Maybe you want to find the cure for cancer. It’s clear that you will need to be one-pointed. Dedicated. Even, maybe, obsessed?  There might be a fine line between a healthy dedication and an unhealthy obsession, and it is not clear where that line should lie. Could one man’s dedication be another’s obsession? If you want to achieve big things, you will have to make sacrifices, but how far should you go?

For example, think of Lance Armstrong, who seemed the very image of the dedicated champion, even overcoming what looked like a fatal cancer, until it turned out that his thirst for success and glory had led him to deceive everyone. Had his dedication gone too far? Had he become obsessed with winning at all costs? If we are aiming high, how do we avoid such a mistake?

If we do find ourselves becoming a little obsessive about our goals, one question we need to ask is, are our goals big enough, are they worth dedicating ourselves to? Perhaps dedication becomes obsession when the goal we aim for is not worth the sacrifices we make along the way. If you were to dedicate your life to collecting Mars bar wrappers, for instance, giving up all your spare time to hunt through rubbish bins, this would be an obsession.

But what actually is worth dedicating ourselves to? I’ve just come out of a supermarket which seems to like to project an image of its workforce as living only to provide happy smiling excellent customer service (although the reality seems more often that the staff devote themselves to ignoring the fact that they are blocking your access to the groceries you want!) I imagine when they advertise vacancies they say they are looking for people with a passion for customer service. Does anyone really have such a passion? You could dedicate yourself to being such an employee, but when it came time to retire, or even be made redundant, what would you have to show for it all?

Perhaps more ambitiously you might devote yourself to a career, maybe in big business. You may need to demonstrate a commitment to succeed bordering on obsession, which your bosses and peers might be glad to describe as dedication. You might have to make a lot of sacrifices along the way – your relationships might suffer, as might your health. But it will be all worthwhile when you finally make it, won’t it? Or will it?

In the past people would often devote themselves to religion, perhaps becoming a monk or a nun and thus sacrificing family life, sex, possessions, even individual autonomy. Nowadays their fervour might seem more like fanatical obsession, reminiscent of the kind of thing that leads turns people into suicide bombers. In today’s world it sometimes seems that sport has taken the place of religion for many people. Some people dedicate themselves to being a fan. They might spend all their spare cash supporting a soccer team, buying replica shirts, following their team everywhere, being absolutely distraught if they lose and ecstatic if they win.  Some fans even have had their ashes scattered on the pitch of their favourite club after their demise. Is this dedication or obsession?

And what about the sporting men and women themselves? If they want to be the best, they will certainly need a prodigious degree of dedication, but as the case of Lance Armstrong illustrates, this can turn into something less than healthy. This also appears to be the case with Oscar Pistorius, someone who overcame tremendous difficulties in his pursuit of athletic excellence, but if some of the stories circulating around his trial are to be believed, turning him into a bad tempered obsessive.

Even setting aside such fallen heroes, we might (rather heretically?) ask what is so good about a gold medal, or winning the premier league? How much are such things worth, really? How much is it worth sacrificing for them? How much dedication/obsession is justified in their pursuit? If you are a top-level sportsman or sportswoman you are probably surrounded by people, maybe including thousands of adoring fans, who would not even dream of asking such a question.  But as the ancient Greek philosopher Socrates is said to have pointed out, the unexamined life is not worth living.

Perhaps one aspect of the answer to these questions is indeed related to our health – in the broadest sense. We can ask ourselves if in the pursuit of our goals we are becoming healthier and, even, happier and more fulfilled. In Traditional Chinese Medicine we have the idea of a person’s destiny; this is not fate, but more like an innate potential. In a way our destiny is who we really are, so that as we gradually fulfil our destiny, we become more and more ourselves. This is a deeply satisfying experience, a humanising experience.

But what is our destiny? As with most things in life, we find out as we go along (or not!) I knew someone who in his youth wanted to be a fighter pilot, but who realised as he got older that  what he really wanted was freedom – which for him was symbolised by a fast jet racing across the sky. So as we move through life we need to be open to our goals changing, or rather be open to finding out that what we thought we wanted is not what we really want. If my friend has clung doggedly to his ambition to be a fighter pilot, maybe he would have become one, but maybe also he would have been secretly disappointed and grumpy. (But then again, for someone else, zooming across the heavens at twice the speed of sound might be part of the journey they need to make.)

From this point of view, dedicating ourselves to a goal which is (at least for the time being) congruent with our destiny will indeed lead us to a more fulfilling life. If on the other hand we find ourselves becoming grumpy, angry, miserable, difficult to live with and ill, it may be that we have become fixated on achieving something which it is not really in our interest to achieve. In such a case we need to take a deep breath and see if we can let go of that goal and follow the advice of the Sufi poet Rumi:

“Let yourself be silently drawn by the stronger pull of what you really love.”

This brings us back to the idea of balance. Balance is not mediocrity; it is not a static thing. We don’t achieve it by sitting on our hands and doing nothing.  If our goals are such that striving for them indeed helps us to gradually realise our destiny, then as we struggle towards them we become more balanced, not less. We draw on energy we did not know we had, which would never have been called forth if we had not aimed high. Of course this is not plain sailing and we will indeed have days when we feel anything but harmonious, but the overall trajectory of our life is in the direction of fulfilment and equilibrium. Far from being obsessed with something which is really of little significance (like winning the premier league or becoming a millionaire!), we dedicate ourselves to something worthy of us and our destiny.

Of course we cannot do all this in splendid isolation; we need help and support. At The Sean Barkes Clinic, this is what we do; using the tools of Traditional Chinese Medicine, we help people achieve the dynamic balance that comes with fulfilling their destiny by optimising our patients’ state of health. For further details, follow this link

Demystifying Chinese Medicine: Why Is It So Good At Treating Back Pain?

Although acupuncture and Traditional Chinese Medicine (TCM) is used in the treatment of a very wide range of health problems, in the West many people associate it especially with the treatment of back pain. NICE (the National Institute of Health and Care Excellence, the organisation responsible for providing the guidelines to the NHS on treatment options for different conditions) lists  a course of acupuncture  as one of the recommended ways of treating persistent, non-specific low back pain. Many people have positive experiences of acupuncture relieving their back pain. So why is TCM acupuncture so good at treating back pain?

The simple answer is experience; acupuncture has been used for literally thousands of years in the treatment of back pain, which was, one can assume, almost as much a problem for first century Chinese as it is for twenty-first century Europeans. Over the centuries then, there has developed a sophisticated and effective way of both diagnosing different types of back pain, and of treating that pain in accordance with the diagnosis – the combination of accurate diagnosis and effective treatment is, of course, the key to any successful treatment.  Traditional acupuncturists today are the heirs to that body of knowledge; and since acupuncture is used a lot in the treatment of back pain, individual acupuncturists also quickly build up their own personal expertise to augment this inheritance.

Of course back pain has also been treated in the West, one way and another, for hundreds of years; perhaps, however, practical knowledge has been lost or discarded due to the twentieth century enthusiasm for tablets as the cure for everything; in particular a hands-on approach to back pain is no longer in favour. (A clinic I once worked in had a telling cartoon on the noticeboard; an old man sits facing a doctor, who is telling him that he has to expect a few aches and pains at his age, and handing him a prescription for some painkillers. The old man then gets up to go, revealing an arrow protruding from his lower back!) Sometimes indeed one finds remnants of  lost skills outside of both conventional and alternative medicine,  in the most unlikely of places; some of my patients had very positive experiences of being treated by a lorry driver who had, apparently,  considerable intuitive and practical skill in relieving muscular-skeletal pain.

A hands-on exam is a crucial part of the diagnostic process in TCM. This reveals quite a lot of useful information to the skilled clinician, who will notice, amongst other things, points and areas of tenderness, the tone of the musculature, variation in temperature, and so on. (Incidentally, it is often a relief to a patient simply to have their back examined in this kind of way: sometimes it seems that it is only when this happens that they feel their problem is being taken seriously, that their experience is validated.)

However, as well as a thorough exam of your back, the TCM clinician will also be interested in other aspects of your health which (you might think) have not much to do with what has gone wrong in your back. This is part of a holistic approach to back pain which integrates the information gained from the exam together with information gleaned from the patient about how they actually experience the pain, what makes it worse and so on, with an overall picture of the patient’s health. Sometimes, indeed, the back pain is simply the most marked symptom of an underlying disharmony.

The acupuncturist thus arrives at a diagnosis which helps him or her understand what is wrong with your back, and what relation this may have to underlying or systemic disharmonies which may either have caused the back problem or be inhibiting the body’s healing response.

It’s important to understand that this diagnosis is distinct from a western medical diagnosis. A TCM clinician will not tell you that you have a disc prolapse or spondylitis; rather they may say you have a Cold-Damp obstruction of the Tai Yang meridian of the back, Liver Qi Stagnation, or Kidney deficiency! This is confusing to most people who naturally assume that the kind of diagnosis made by a GP or other western health professional is the only real kind of diagnosis there is. To understand this, it may be helpful to use the analogy of a map. You might be used to using one kind of map (a road map perhaps), but this does not mean that any other kind of map (an ordnance survey map, say) is wrong; it simply maps the area in question in a different kind of way. Similarly there are different ways of ‘mapping’ a human being, which can be useful in different situations. So a TCM acupuncturist makes a diagnosis using the TCM map, not the western medical map.

(Of course if you are told, say, you have Cold-Damp obstructing your meridians, you may well feel none the wiser, although in fact you will probably also be none the wiser if your GP tells you that  you have spondylitis. In fact, even if they tell you it is arthritis, you will probably only have a very vague idea of what arthritis is!  But in brief, back pain means that the flow of Qi in some of the meridians which flow through your back are blocked; in Chinese medicine, this is what pain essentially is, an impairment of the free flow of Qi. Sometimes this blockage is due to cold and damp as it were getting into your back, in much the same way they might get into an old house. This is of course more likely to happen if you live in a cold, wet climate, and if you do not take care to wrap up properly, but it may also be due to poor dietary choices or other such factors.)

Once established, this diagnosis  leads to a clear set of treatment principles, aimed at both alleviating the back pain directly and restoring health and wellbeing holistically – which in turn further helps alleviate the pain, promotes healing,  and starts to resolve the underlying imbalance behind the pain.

Whilst acupuncture is often the treatment of choice in this treatment programme, the TCM  clinician has more than one arrow in his or her  quiver, tried and tested treatment modalities which he or she may use in addition to acupuncture, depending on the diagnosis. These include Tuina massage, cupping, moxibustion, herbal ointments, gua-sha and electro acupuncture (a more recent addition to the therapeutic armoury). Furthermore, the diagnosis also may lead to the clinician making specific informed suggestions about things we can do ourselves to speed up the healing process.

This makes it clear that there is a lot more to the treatment of back pain than simply sticking a few needles in the general vicinity of the pain. The reason why TCM is so effective for back pain is that it builds up a sophisticated and accurate diagnosis and then tailors its treatment in the light of that diagnosis.

Mind, Body and What?

Sometimes when we want to make it clear that we are referring to a human being in their totality, we might use phrases like ‘body and soul’ or ‘mind, body and spirit’. But what do these words mean? We may think we know what a body is, and we may even think we know what a mind is (although we might find ourselves having a bit of difficulty if pushed to define it), but what about words like ‘soul’ and ‘spirit’? Surely these are candidates for the vaguest words in the English language, and indeed one might suspect that they are sometimes used by people who have a vested interest in keeping things nicely vague.

In fact the English words ‘soul’ and ‘spirit’ both have their origins in ancient words meaning ‘breath’, reflecting the observation  that someone who is breathing is alive, whilst someone who is not breathing is dead. A dead person may look the same as they did when alive, except that they are no longer breathing, so one can understand how people would have correlated the breath with the apparently departed essence of the deceased, their soul or spirit. Belief in an afterlife of some form or other often rests on the belief that there is something essential within us that animates our body during life and then leaves at death. The rise of materialistic philosophy means that, perhaps, fewer people believe in life after death or in the existence of an immaterial essence within us. ‘Soul’ and ‘spirit’ are not part of the (official) vocabulary of western science or medicine.

So perhaps these days it would be better to just talk of ‘mind and body’. But on the other hand, maybe there are important, even crucial, aspects of human beings which the phrase ‘mind and body’ does not grasp. To begin with, one of the common ways the word ‘spirit’ is used, as for example in the phrase ‘fighting spirit’, is to denote something like enthusiasm, vigour, liveliness; we may say of someone that they are a spirited individual, or that they are high spirited. In this sense spirit seems to be used to indicate how alive someone is. A healthy person is one whose body functions smoothly, who is of sound mind, but also one who is quite simply very alive. In Traditional Chinese Medicine, a clinician will assess the health of a patient’s spirit by, among other things, noticing their eyes (‘the windows of the soul’ as the English phrase has it); someone with a healthy spirit has sparkling, lively eyes, whereas someone whose spirit is impaired may have dull, lifeless eyes.

Similarly, the word ‘soul’ may still have some value. Think of how it is used to talk about music, and how we might say of someone that they are ‘soulless’. A work of art may be the product of great technique, but if it has ‘no soul’, it will not touch us; a person may say all the right things, but if he or she seems soulless, we will not trust them.

The reality is that the human being is a complex and marvellous thing, and the phrase ‘mind and body’ just does not do enough to capture him or her. In particular if we are considering things like health and well-being, it is crucial that we do not focus solely on the body or even solely on the body and mind (especially if we want to think of the mind as simply a bunch of physical processes in the brain.) We may also need to ask, how is our spirit? What is the condition of our soul?

Spirit and soul in this understanding are not ‘things’. Experiments such as the one conducted at the start of the twentieth century to try to weigh the soul by weighing a person just before and just after death (when the soul, presumably, will have flown) are of course wholly misguided. Spirit and soul are not things to be measured. There is not a spirit inside us in the way there is a pituitary gland inside us. These are words which are not to be taken too literally.

In fact, it is best not to take even the phrase ‘mind and body’ too literally, if by that we mean the mind is one kind of thing and the body another. Where does mind end and body begin? Since the influential French philosopher Rene Descartes in the seventeenth century, westerners have tended to think of the body as a physical thing, a machine, inside of which is something else – mind, soul or spirit – the ‘ghost in the machine’. Modern science may have eroded this dualistic way of thinking at least to an extent, but it might be instructive to look at how Traditional Chinese Medicine views the individual, for it has no place for such dualism. Here a person is composed of ‘three treasures’ – Jing, Qi and Shen. Shen, often translated as ‘spirit’ or ‘mind’, is nevertheless not wholly immaterial but simply a more refined form of Qi, just as Jing or ‘essence’ is a more condensed form of Qi. In other words the three treasures are all Qi, which is neither wholly material nor wholly immaterial.

So instead of ‘body, mind and spirit’ we could talk of Jing, Qi and Shen, which in some ways is less misleading, since it does not depend on what turns out to be a false distinction between the material and the immaterial. But the main thing is that, whatever expression we use, we do not take it too literally, and we do not use it to exclude, ignore or forget about any aspect of that marvellous and complex phenomenon, the human being.

Treating Psoriasis with Acupuncture

Ancient Chinese Medical Knowledge in the Modern World

The Chinese have been using acupuncture to treat psoriasis for thousands of years—descriptions of the disease are found in the earliest Chinese medical texts. At the Sean Barkes Clinic we follow in this tradition.

Treatment begins with a careful examination of the affected parts of the body and a detailed consultation in which we discuss not only how you experience the psoriasis (Does it itch? Does it feel hot? Does it get worse if you are stressed?….) but other aspects of your health as well. This is because our treatment is holistic and we consider that what is happening on the surface of the body in some way reflects various imbalances deeper within. You could say that we don’t so much treat the psoriasis as the person who is suffering from the psoriasis.

From this perspective, psoriasis is just the manifestation of an underlying imbalance and we use our understanding of the principles of Traditional Chinese Medicine (TCM) to figure out what this imbalance is. So when you first come for treatment we do a detailed consultation in which we ask quite a few questions about your health, everything from how you sleep to the state of your bowels, from headaches to perspiration; we are looking for clues about what is going on inside. We take your pulse and look at your tongue (if you don’t mind sticking it out at us!). All this helps us understand, in terms of Chinese medical theory, what is giving rise to the psoriasis.

Once we have this understanding, which we will share with you, we can use acupuncture to start to resolve this underlying disharmony. This involves inserting a few very fine needles into key points on the body, called acupuncture points. We choose points which enable us to regulate your Qi (a Chinese word used to collective function and vitality of an organism. Literally, ‘life-force’ or ‘vital energy’) and move you in the direction of balance and full health. The needles are so fine that you probably won’t even feel them go in; its certainly not like having an injection! Most people find treatment itself deeply relaxing.

Our treatment is thus individualised to each patient – no two people with psoriasis are the same, and we think it is important that treatment reflects this. We can also, therefore, discuss with you other things you may be able to do that will help restore your health.

The holistic approach means that we look not only to reduce or even eliminate the psoriasis, but to help you to even better health overall.

Our treatment of psoriatic arthritis follows the same principles; again we see the joint pain as a manifestation of a deeper disharmony.

Whilst Chinese Medicine has been treating psoriasis for thousands of years, there has yet to be very much scientific research done on its effectiveness for this condition. One large scale Chinese study of 600 psoriasis patients treated with TCM found substantial improvement, with at least 60% of the skin rash disappearing, in over 500 of the patients, with 370 of these classified as ‘cured’.

Finally, a little story about one of our patients. She initially came for treatment for Raynaud’s disease – she felt the cold very easily, and especially her hands and feet would get painfully cold. We treated her with acupuncture and moxibustion (where we warm the acupuncture point and body tissue surrounding it with the herb artemisia vulgaris, or mugwort), aiming to stimulate and invigorate the flow of Qi through her limbs. After three or four treatments this was working very well, and we suggested that we might also be able to help with her psoriasis, which she had been suffering from for most of her adult life (she was in her mid-60s). She was surprised to hear that we could treat psoriasis and, buoyed by the improvement in her health so far, keen to find out if it would help; she had been used to keeping her arms and legs covered whatever the weather, and did not feel able to do things like go to the swimming baths. .

From our point of view, in this case there was a definite link between the cold limbs and the psoriasis, both being at least in part due to impairment of the flow of Qi through the limbs, resulting in coldness and lack of nourishment to the skin. Again the treatment proved effective – although for a while there were occasional flare-ups of the psoriasis, in general there was a big improvement, which we managed to sustain with monthly ‘top-up’ treatments. You can read this patient’s own words (and those of her grateful husband!) here.

What Counts As Success?

I‘ve noticed a few stories in the press recently of highly successful people coming to unfortunate ends. There was a top executive at a Swiss insurance firm who apparently committed suicide due to the stress he was under at work. The other  week a student intern at a US bank in London was found dead at home, and although the cause of death is as yet not known, questions have been raised about the working hours of young people in such positions. And the chief executive of Lloyds bank was forced to take 6 weeks off a few months ago because of extreme exhaustion.

Of course most of us might not so far up the ladder as some of these people, but their stories raise pertinent questions for all of us. One of these questions is, how do we measure value in our life? What counts as success?

Our answer may be to do with happiness, family, enjoyment, health, love and so on, but these are  things that cannot be quantified. Whereas our bank account and salary (if we have one) can. We might not be always too sure how happy or fulfilled we are, but a big number on our payslip is there in black and white. And a big number means we can buy things. Buying things, especially expensive things, can bring a beguiling sense of achievement and satisfaction. If we can do this, we must really be somebody. Our life must have value. Thus it can be tempting to find value in money.

This in fact is one of the central myths we live by these days; the myth that money is what brings value to our lives. If you have a lot of it, people will treat you as if you are worth something. If you have no money, you may feel worthless. Many of us would deny we live by such a myth, but its hold on us can be all the stronger because we do not recognise it, and do not want to recognise it. After all, it is drummed into us night and day by advertising, politicians, and much of the media.

Rejecting this myth, however, and finding a better way of valuing ourselves and others, does not mean we have to go to the other extreme. Money is clearly not the root of all evil; it gives you the ability to do a great deal of good. The most effective altruists in history, the individuals who have done the most good for others, are, according to the philosopher of altruism Peter Singer, no other than Bill Gates and his wife, and Warren Buffet, billionaires all. Money is clearly neither good nor bad, it depends on what you use it for (and how you get it!) A better way of measuring value, therefore, may be in terms not of what we have, or what we get, but in terms of what we give. This provides us with a neat way of turning the myth on its head.

Money, therefore, would seem to be value neutral – it’s what we do with it that counts. However, in practice our relationship with money is not that simple. Where money is concerned we might have to admit that we are not rational animals. What we are in part, possibly, are greedy animals. That might sound a bit harsh; we don’t like to think of ourselves as a greedy guts, but in fact we are expected to be greedy – it might even be that our economy depends on our being greedy! Greed is the norm, we don’t even notice it at work in our lives. We’ve got 30 TV channels, but we want 40. And maybe a bigger TV to watch them on. We’ve got a perfectly nice house, but we want a bigger one. In a better neighbourhood. We’ve got a perfectly delightful handbag, but we want a new one. We’re bored with our car, we want a change. All perfectly normal responses in our world. So what is extravagant or unheard of for one generation becomes the norm for the next. To keep on upgrading in this way we need money. What used to be a luxury is now something we cannot live without (or so we think.) We need more money so we can spend more.

One consequence of such an approach to life is that we are never satisfied or content, and if that is the case then perhaps we are not really happy either. There is a nice Buddhist story about a disagreement between the Buddha and a king as to who was the happier. The king insisted that he was happier – he had great riches and power after all, several wives and plenty of elephants! But the Buddha, who had not very much at all in the way of possessions, asked him whether he could just sit down in a simple room and be happy for an hour. The king thought he could do that. Two hours then? Probably. How about all day? The king hesitated. The Buddha pointed out that he could sit still all day and be perfectly happy. So who was really the happy one?

Happiness and health, moreover, are closely related. We should perhaps beware of a life dominated by greed, including socially acceptable greed, for it can damage our health. Perhaps like the chief exec of Lloyds we can end up working ourselves into the ground to be ‘successful’, only to find that ‘success’ has made us ill. Once we start skipping meals, or eating whilst we work, once we start working late and missing sleep, once we start using up energy we do not really have, we are asking for trouble. Acupuncturists like me see a lot of people with problems as diverse as migraines, IBS, insomnia and panic attacks which often seem to be at least in part due to what they are doing to themselves in the name of ‘success’. Of course if you are young and have a strong constitution, you can get away with such things for a while, but even then you risk setting up bad habits which will take their toll later on in life.

More subtly, the sense of lack, the gnawing emptiness at the centre of greed that is never really filled by the big salary and expensive purchases, may itself be a cause of ill-health. Perhaps it is a factor in the widespread modern mental health problems such as depression and anxiety; maybe it is also connected with digestive problems and eating disorders, as we unconsciously try to fill up the gap with food, recognising that we need nourishment, but not recognising quite what kind of nourishment we need.

This is not to say that we should sit around like a cabbage, achieving nothing. Achievement is important, but it is a question of what counts as achievement. A big number on a bank statement or a new wide-screen TV don’t count. Driving ourselves to try to fill up the emptiness at the heart of greed is the problem. Achievement should come as the more or less natural expression of the things in us which are the opposite of greed – things like love, inspiration and compassion. In short, a life characterised by a giving of ourselves rather than one by taking for ourselves.

Treating Psoriasis with Acupuncture – Ancient Chinese Medical Knowledge in the Modern World

The Chinese have been using acupuncture to treat psoriasis for thousands of years, descriptions of the disease are found in the earliest Chinese medical texts. At the Sean Barkes Clinic we follow in this tradition.

From this perspective, psoriasis is just the manifestation of an underlying imbalance and we use our understanding of the principles of Traditional Chinese Medicine (TCM) to figure out what this imbalance is. So when you first come for treatment we do a detailed consultation in which we ask quite a few questions about your health, everything from how you sleep to the state of your bowels, from headaches to perspiration; we are looking for clues about what is going on inside. We take your pulse and look at your tongue (if you don’t mind sticking it out at us!). All this helps us understand, in terms of Chinese medical theory, what is giving rise to the psoriasis.

Once we have this understanding, which we will share with you, we can use acupuncture to start to resolve this underlying disharmony. This involves inserting a few very fine needles into key points on the body, called acupuncture points. We choose points which enable us to regulate your Qi (a Chinese word used to collective function and vitality of an organism. Literally, ‘life-force’ or ‘vital energy’) and move you in the direction of balance and full health. The needles are so fine that you probably won’t even feel them go in; its certainly not like having an injection! Most people find treatment itself deeply relaxing.

Our treatment is thus individualised to each patient – no two people with psoriasis are the same, and we think it is important that treatment reflects this. We can also, therefore, discuss with you other things you may be able to do that will help restore your health.

The holistic approach means that we look not only to reduce or even eliminate the psoriasis, but to help you to even better health overall.

Our treatment of psoriatic arthritis follows the same principles; again we see the joint pain as a manifestation of a deeper disharmony.

Whilst Chinese Medicine has been treating psoriasis for thousands of years, there has yet to be very much scientific research done on its effectiveness for this condition. One large scale Chinese study of 600 psoriasis patients treated with TCM found substantial improvement, with at least 60% of the skin rash disappearing, in over 500 of the patients, with 370 of these classified as ‘cured’.

Finally, a little story about one of our patients. She initially came for treatment for Raynaud’s disease – she felt the cold very easily, and especially her hands and feet would get painfully cold. We treated her with acupuncture and moxibustion (where we warm the acupuncture point and body tissue surrounding it with the herb artemisia vulgaris, or mugwort), aiming to stimulate and invigorate the flow of Qi through her limbs. After three or four treatments this was working very well, and we suggested that we might also be able to help with her psoriasis, which she had been suffering from for most of her adult life (she was in her mid-60s). She was surprised to hear that we could treat psoriasis and, buoyed by the improvement in her health so far, keen to find out if it would help; she had been used to keeping her arms and legs covered whatever the weather, and did not feel able to do things like go to the swimming baths. .

From our point of view, in this case there was a definite link between the cold limbs and the psoriasis, both being at least in part due to impairment of the flow of Qi through the limbs, resulting in coldness and lack of nourishment to the skin. Again the treatment proved effective – although for a while there were occasional flare-ups of the psoriasis, in general there was a big improvement, which we managed to sustain with monthly ‘top-up’ treatments. You can read this patient’s own words (and those of her grateful husband!) here.

Achievement and Non-Achievement: the Middle Way to Better Health

One of the high street banks has an advert all over the place at the moment claiming its goal is to help us with our goals. This might strike one as unlikely, but at least it reminds us that this is the time of year when we might want to be thinking about our goals for the future year (and years), about what we want to achieve in our life.

Some people are of course more goal-orientated than others, but I think everyone has goals – even if they have widely differing ways of relating to those goals. Sometimes, perhaps, our goals are not very conscious, and it may serve us well to see if we can make them a bit more conscious. What are we trying to achieve? What really motivates us? Where do we want to be in a year’s time, ten years’ time…? Some people even approach this question by thinking about what they would like said about them at their funeral. Sometimes as we mature we need to clarify what we want to achieve, as opposed, perhaps, to what we may think other people expect us to achieve.

On the other hand, maybe sometimes we can become over-focused on some of our goals. I remember in my early twenties walking the Pennine Way long distance footpath. I had two weeks to cover about 250 miles, and it turned out to be two weeks of heat wave (older readers may remember those). So I walked through some of the most beautiful countryside in England (and a bit of Scotland, where it rained.) but I was so focused on getting to the next camp-site, not getting lost on the way, not getting dehydrated etc., that maybe I did not appreciate the countryside so much. Such an experience becomes a metaphor for how I sometimes live life (if I am not careful), and as a metaphor maybe it applies to a lot of people in our society.

If we live in such a driven, goal-orientated way, not only do we miss some of the most rewarding bits of being human, we can in the end make ourselves ill. For one thing we can start to over-reach ourselves energetically, using up inner resources that we do not replenish sufficiently, perhaps working long hours, not always eating well or giving ourselves time to eat (and digest) well, doing without sleep and so on. Sooner or later this will have consequences for our health. If we are young and have a strong constitution we can get away with such a lifestyle for a while, but as we get a bit older, or if we are not blessed with such a strong constitution, we will burn ourselves out, whether this results in migraine headaches, high blood pressure, chronic fatigue syndrome or something else. Of course we may tell ourselves that we don’t have time to be ill, pop a pill to take away the symptoms, and keep going, or we may rush back into the fray after illness without giving ourselves time to recover properly; but we only store up trouble for ourselves for later- eventually we will have time to get ill, whether we like it or not.

We might want to ask ourselves just why we are pushing ourselves so hard. It might of course be something as simple as plain greed – maybe we want to make a lot of money – but it might also be coming from some hidden guilt or even self-hatred – we feel we are not good enough as we are; we continually need to prove ourselves. Or maybe it is insecurity – we don’t want to be left out or left behind. Sometimes these motivations are mixed up or confused with our responsibilities and desire to help others. In Traditional Chinese Medicine emotions like guilt and fear can themselves be a cause of ill-health, and allowing ourselves to be driven by them only feeds them and strengthens their grip on us.

There is a difference between this kind of driven life, which at root involves repeated acts of unkindness to ourselves, a sort of inner tyranny, and a life of a person who  achieves a lot out of the sheer exuberance of loving what they are doing. Being driven is not the same as being inspired; it’s the former that can do us harm; although even the inspired person may need to make sure they look after themselves in terms of diet, sleep, rest and relaxation etc.

On the other hand, the opposite of the driven life is the life lacking in goals and achievement – the aimless. As mentioned above, everyone has goals, because everyone at root wants to be happy. But what happens when, maybe, we become discouraged by our failures, when our fear of failure leads us to abandon our goals before we have really tried to achieve them. Sometimes we may be setting ourselves impossibly difficult goals, so that we are set up to fail. Or if our goals are necessarily difficult of attainment, we need interim or short term goals which we can achieve. For instance, if we want to be a millionaire, we may need a shorter term goal of making our first £10,000. If our goal is to run a marathon, we might need first of all to be able to run a mile! As the Chinese say, ‘the journey of a thousand miles begins with a single step.’  This is important because self-confidence and self-esteem may in part depend on our ability to achieve our goals. When we do run that mile or make that £10,000, we need to be able to feel satisfied and encouraged, not dispirited in the face of the more distant goal.

Apathy and feeling dispirited can also can lead to illness. In Traditional Chinese Medicine one of the common causes of health problems lies in ‘stagnation’, when what the Chinese refer to as ‘Qi’ stops flowing as freely as it should. This can happen if we as it were deny our goals. In classical Chinese thought every person has a ‘destiny’ – not indeed something that we are fated to experience, but rather a direction in which our life naturally unfolds. Someone living their destiny is someone who is, as we say in English, ‘coming into their own’, someone who is as it were becoming more fully who they really are. If for some reason we are avoiding moving in this direction, which is to say trying to realise our real goals,  we will feel stuck, we will stagnate, and eventually this will manifest physically in a wide range of symptoms, and unless we get back to trying to actualise our destiny these symptoms will gradually get worse until in the end we may become seriously ill.

Of course the driven person no less than the apathetic person may be avoiding their destiny. Buddhists speak of two kinds of laziness – the laziness of laziness (plain laziness!) and the laziness of busy-ness, when we avoid the important thing by keeping busy, even by becoming highly successful in something that does not in the end matter all that much.

So, if that bank I mentioned really wants to help us achieve our goals in 2013, what it needs to do is to help us to become clear about what they are, help us to make sure that if our ultimate goals are distant that we also have more short term goals which we can realistically reach, stepping stones along the way so to speak. It also needs to help us not to become too fixated and obsessed by our goals, so that if we achieve them we achieve them at the expense of other things which really are more important. We need to be striving to achieve things in our life, but that striving needs to have a certain lightness to it, even some playfulness perhaps. We may or may not reach the end of the metaphorical long distance footpath, but we need to appreciate the scenery en route, not to mention the company of our fellow travellers.

Winter’s Happy Secret – Avoiding Seasonal Depression

I sometimes wonder whether people in other cultures suffer from seasonal affective disorder, or SAD, in the way that many people in the west seem to do. SAD is a mood disorder in which people get depressed at a certain time every year, usually in the winter months. Perhaps the prevalence of SAD, and the fact that many other people I know talk about feeling a bit glum in the winter, points to something not quite right in our relationship with nature’s seasonal cycle. Of course some might say that it is just a matter of  people getting depressed because of the lack of sunlight, but that simply begs the question of why depression should inevitably follow from such a lack; and also the research does not back up such a simplistic view. For instance, one study found that SAD was twice as common in a sample of Americans as it was in a group of Icelanders living at much higher latitudes¹.

It is axiomatic in Traditional Chinese Medicine that our lives should be lived in accord with, even in harmony with, the changing seasons.  This cyclic changing is spoken of in classical Chinese thought as the movement from Yin to Yang and back again. Winter is the time of Yin, and summer is the time of Yang. Yin relates to coolness, darkness, interiority, but also to nourishment, stillness, receptivity. This is what the ‘Huang Di Nei Jing’ (the Yellow Emperor’s Inner Classic), one of the foundation texts of Chinese medicine, written some two thousand years ago, has to say about winter:

“During the winter months all things in nature wither, hide, return home and enter a resting period, just as lakes and rivers freeze and snow falls. This is a time when Yin dominates Yang. Therefore one should refrain from overusing the Yang energy. Retire early and get up with the sunrise, which is later in winter. Desires and mental activity should be kept quiet and subdued, as if keeping a happy secret .Stay warm, avoid the cold, and keep the skin covered. Avoid sweating. The theory of the winter season is one of conservation and storage.”

It may be that our culture does not do Yin very well – we have an overemphasis on Yang, on going out, doing things, making noise, being active and so on. All very well in the summer, but in winter time a different emphasis is needful. We need to turn inwards a little, nourish and nurture ourselves, reflect, meditate, ponder.  Sit in front of the fire and tell stories. Listen to the wind and rain hammering on the windowpane.

Maybe we don’t realise this. We think we should still be out there playing in the sun, so we get deeply out of touch with the way the year turns around and so end up depressed. Or maybe even sometimes depression is our misinterpretation of our natural turning inwards towards the Yin. We can’t recognise that deeper sense of self, we can’t relate it to how we think we should be (or how we are told we should be – think adverts, for instance, which usually have a vested interest in our looking outwards for satisfaction). So, we start to think that there is something wrong with us, when in fact there is only something wrong with how our culture tells us we should be.

More generally, some people choose to have a regular acupuncture treatment at the time of transition from one season the next. Such treatment can help us to make the subtle adjustments necessary to remain in harmony with the natural world which we are inextricably part of, and this in turn not only makes us feel better but strengthens our body’s ability to wards off  illness. Having such a treatment as autumn gives way to winter helps set us up to make the most of winter, avoiding SAD and, like nature herself, building up our resources so as to be ready for the return of the Yang which comes with the new growth and vitality of the spring.

1. Magnusson A, and Stefansson JG. 1993. Prevalence of seasonal affective disorder in Iceland. Archives of General Psychiatry 50: 941-946.

Dying for a Good Night’s Sleep?

 

The news this week is bad for people taking sleeping tablets; a large scale American study of over 1,000 people taking a wide range of drugs such as temazapam and zopiclone to help with sleep problems, found that people taking them were 4.6 times more likely to die over a 2.5 year period than people not taking such drugs. It is unclear why that might be. It’s not much fun being an insomniac at the best of times, but some people will probably have even more trouble getting off to sleep now, since they will be worried that their medicine might be killing them!

 

The other problem with such drugs is that they don’t really address the underlying disharmony in a person’s being that is interrupting the natural cycle of waking and sleeping, one of the most fundamental natural cycles which are described in the classical Chinese tradition in terms of the dynamic equilibrium between Yin and Yang. Whereas Yang is to do with light, activity, moving outwards, Yin is darkness, stillness, inwardness. Night time, the time to sleep, is the Yin time, and insomnia is strongly suggestive of a relative lack of Yin within the individual‘s body and mind. Sleeping tablets don’t do anything to restore that harmony – if they did, they certainly wouldn‘t be increasing the chance of a premature demise – they just knock you out.

 

Traditional acupuncture treatment of insomnia begins with an understanding of just how that balance has been disrupted. Once we are clear on that, we can see how acupuncture can help restore it, and we can perhaps suggest other things – dietary changes for example – which may help.

 

When I treat patients for sleep problems like this, I often mention my own pet way of falling asleep if I am a bit too restless for it to happen like it should (assuming I have not been foolish enough, yet again, to drink too much coffee!). What I do is to imagine myself getting up and going downstairs and out of the house. I do this in as much detail as I can, for instance imagining picking up my key, unlocking the door, locking it behind me, etc. I make my way down the road and on to some nearby spot in the countryside, perhaps by the local river (in my imagination, I can travel quite quickly if I want to go some distance.) Here I find there is something like a staircase down into a hole or cave in the ground, and I descend down these steps. From then on , if I am still not asleep, I let my imagination have a free rein – so I might find myself meeting someone I know down there, or encountering an animal, or really whatever happens. However, I try to keep moving further down. Usually I fall asleep doing this, but even if it takes a while, at least I have an interesting time!

 

I suppose this is something like a deliberate attempt to enter the dream world, or the unconscious. In classical Chinese terms, going down into the dark is definitely moving from the Yang to the Yin, which is what needs to happen to fall asleep.

 

Anyway, I don’t suppose this works for everyone – perhaps you need a fertile imagination – and there have certainly not been any clinical trials to support its use – but at least it is not likely to be fatal!