May is Mental Health Awareness Month, and to honor that, this post is about how Traditional Chinese Medicine understands our mental, emotional, and spiritual selves. Acupuncture and Chinese Herbal Medicine can be very useful therapies to treat common mental health conditions, especially in conjunction with psychotherapy and pharmaceutical medication (when appropriate.) Common mental health conditions we see in our clinic include anxiety, depression, post-partum depression, bipolar disorder, obsessive-compulsive disorder, and eating disorders. Acupuncture can also be a great way to help manage stress. Understanding the Shen, or spirit, also allows acupuncture and Chinese Herbal Medicine to be helpful in treating issues such as a feeling of lack of direction or decisiveness, an inability to plan, a hard time getting out of one's own way, a lack of willpower or intention, or a tendency to hyper-analyze and overthink situations.
From a Traditional Chinese Medicine (TCM) viewpoint, each system in our body exerts an effect on the physical, mental/emotional, and spiritual levels. This means that pathology in one level (ie, chronic pain) can be related to pathology in another level (ie, chronic fear or feeling of worthlessness). We can therefore treat both the physical, mental/emotional, and spiritual aspects of pain or suffering using the same acupuncture points and sometimes even the same Chinese herbs.
The spirit, in TCM, is called the Shen. In Daoist thought, the Shen is referred to as one of the Three Treasures in the body – the other two being Jing and Qi. While there is no direct translation for these concepts in English, you can roughly think of Jing as being your genetic make-up, Qi as being your energy and vitality, and Shen as being your spirit and mental capacity. In holistic health terminology, you frequently hear the term "Mind Body Spirit." In TCM, you can think of it like this: every acupuncture point, every herb, every energy system exerts an effect on each of these levels. The Mind corresponds to our mental and emotional selves, the body corresponds to our physical being, and the Spirit corresponds to our Shen.
In Traditional Chinese Medicine, we understand the Shen to be further subdivided into multiple aspects of Spirit. Each of these aspects is associated with a physical and emotional system in the body. Therefore, pathology in one level can lead to problems in another. With acupuncture and Chinese Herbal Medicine, we seek to bring these different levels back into balance with one another to promote health and healing.
The 5 aspects of the Shen:
Each of these 5 subdivisions of Shen is linked to one of the Five Elements, which are fundamental energetic forces that govern the natural world and also our physical bodies. (Learn more about the Five Elements here.)
Shen: The first of these subdivisions is also called the Shen. The Shen is connected to the Fire element, and is thus closely linked to the Heart. We often say that the heart is the seat of the emotions in Traditional Chinese Medicine, and the Heart Shen governs the emotions. Just like each energy system is associated with a physical part of the body, each system is also associated with an emotion. The Heart Shen oversees the balance between these emotional systems to ensure we experience the full range of human emotions without having one pattern dominate us. The Heart Shen is also closely linked to our awareness and vitality – it is the spirit of a person that twinkles in their eyes.
Zhi: The Zhi is roughly translated as “will-power” and is linked to the Water Element and the energy of the kidneys. Zhi is the force inside of us that allows us to set an intention and see it through, to push through challenging times and emerge on the other side. It is our drive, our perseverance, and our spiritual effort. It is the part of us that doesn’t let us give up.
Yi: The Yi is associated with the Earth element and the energy of the Spleen. It is our intellect, our mental and analytical capacity. It allows us to learn, to study, to make distinctions and decisions. When it is not in balance, one may experience diminished mental acuity or an inability to discern or separate what is important from what is not – this manifests as excessive internal chatter, overthinking, or destructive pensiveness.
Po: Ok, so here is where things get a little more spiritual. Some people really like this and it resonates with them – others don’t. But stay with me, I think that there is wisdom within these ancient Daoist beliefs that help guide us to health in a modern context. In Daoist thought, the Po is the part of our spirit make-up that only lives as long as our physical body. The Po is associated with the Metal element, and thus the Lungs. It is born when we are born and dies when our physical bodies die. (ie, with the last breath of the lungs.) This is important in a clinical setting, because the Po and the lungs are often effected when someone has lost the will to live or to keep fighting to stay alive. By understanding the connection between this spirit idea and the way it manifests in our physical bodies, we can better prevent these kind of desperate feelings or help a terminal patient come to terms with their illness.
Hun: The Hun, unlike the Po, is the part of our spirit make-up that, in a traditional Daoist context, is thought to exist after death. It is associated with the Liver system and the Wood element. Called “the ethereal soul”, the Hun is associated with long-range planning, visioning, and goal-setting. It is also closely linked to sleep, and an imbalance in the Hun energy can lead to the Hun “wandering” at night, causing restless dreams or fitful sleep. Clinically, understanding the energy of the Hun is helpful in supporting patients who are at a loss as to what to do next, who have trouble seeing where they want to be in the future, or, conversely, who are too attached to a certain idea of a future to let it go.
These five aspects combine to form our Shen, or our Spirit.
From an acupuncture perspective, when treating mental health conditions, I think about both these aspects of Shen and also the emotional aspects at play (ie, grief, sorrow, loss, joy, anger, frustration, fear, worry, heartache.) Understanding this interplay between the spirit and the emotions, as well as the interactions with our physical selves, allows me to tailor treatment according to where each individual patient is at on their journey, and promote movement towards a state of balance, integration, and health.