When you have serious digestive problems, it can disrupt your whole life!
- Maybe health problems have forced you to rearrange your daily routine and schedule to suit the symptoms.
- Perhaps you dread social events centered on eating and food, because you can only tolerate certain foods, making things socially challenging.
- Most of us hear the message that diet is the ultimate foundation of digestive health. There is always some new diet promising relief – you’ve likely tried them all. You might have gotten some relief from cutting out certain foods, but you feel like this hasn’t really solved your problem.
- Despite your efforts, you find that you still have a very restricted list of foods. On the other hand, your friends seem to thrive on diets including all kinds of foods you’d never be able to touch!
- Perhaps you are taking a laundry list of supplements and probiotics, but it’s not clear how much of an effect these are having.
- Maybe you have an official medical diagnosis and you were told you will have to struggle with these issues for the rest of your life
If you recognize yourself in any of these descriptions, then you know well how damaging chronic digestive problems can be to the enjoyment and flow of everyday life. Having to manage all of this is exhausting, and doesn’t give you time for much else. Fortunately, there are solutions beyond just tinkering with your diet and adding another supplement.
For thousands of years, Chinese Medicine has understood the importance of the digestive system to human health. Chinese medical theory refers to the digestive organs as “the center” around which the rest of your body’s systems operate. As Chinese Medicine practitioners, we understand that when your center is strong, the rest of you is strong. When the center suffers, so does everything else. And we have time-tested methods of improving your digestive system, methods that go immediately to the source of your health issues.
Allow me to explain how our approach to digestive problems is different
Chinese Medicine likens the digestive system’s role within the body to the Earth or Soil in the natural world. Just as soil can take in fluid and seeds and transform them into verdant plant life, the digestive system can receive and transform food and drink into energy and nourishment for the body.
Let’s run with this metaphor of the digestive system as soil.
Consider planting some special heirloom seeds. You get the perfect seed, plant it, tend to the seeds carefully – a lot of work! Consider then discovering that the quality of the soil itself is poor, or has been overwhelmed by a series of droughts or floods, or was damaged through misuse of chemical fertilizers and aggressive farming techniques. Then, it doesn’t matter how potent our seeds are, or even how much we water them. They won’t be able to take root!
If we want to grow anything, we need to address the quality of the soil.
Making clearer the metaphor, planting seeds, tending and watering to them represent following a balanced whole foods diet. Taking probiotics when needed and learning more about practices like mindful eating can also relate to this tending principle. We can relate the idea of chemical fertilizers to the impacts of antibiotics or other stressors on gut microflora. We can understand the droughts and floods as the effects of other organ systems on the digestion, such as the nervous system.
What you eat does play a critical role in digestive health, but the digestive system itself needs to be functioning well enough for what you consume to be properly received. You can eat an extremely clean and healthy diet, but if you aren’t processing nutrients efficiently, this isn’t going to make much of a difference.
This is where Chinese Medicine comes in!
Regular acupuncture treatment and herbal medicine are treating your terrain, improving the quality of your soil. Another way of putting this is that optimizing your body’s ability to better assimilate what it takes in, making your gut a more inviting place for beneficial microflora, and helping to make sure that your digestive organs are working in harmony with the rest of your body by regulating the nervous system, the endocrine system and the immune system.
And while, yes, you should avoid triggers to your digestive system, we also want to make it so that if your body does encounter the occasional stressor, it can respond more gracefully – without setting off a cascade of uncomfortable or debilitating reactions.
Join us for the first Watershed Wellness holiday food drive – in partnership with the Oregon Food Bank
The cold and dark days have finally arrived, and the only time we’re spending outside these days is to stack firewood or gather bundles of leaves from the lawn. Not without its merits, however–winter is a wonderful time to spend time with loved ones, maybe curl up with a good book and a fire, and honestly, who doesn’t love winter squash?
That said, it’s not an easy season for everybody.
Winter months are tough for families who are struggling to put food on the table. Not everyone has access to groceries. In the spirit of the season this year, Watershed Wellness has decided to partner with Oregon Food Bank to bring you our Winter Food Drive for 2018! Help us help hundreds of families in Oregon have a better winter this season by donating non-perishable food.
Also, for our beloved clients, we’ve decided to run a little drawing for those of you who have appointments during the drive & want to participate.
Details can be found summarized below, or by downloading the flyer, or even checking out our social media accounts regularly.
- We’ll be collecting food for the Oregon Food Bank from November 23 to December 29
- Food collection is centered on the Portland WW location, but Astorians, get in touch if you want to be involved!
- A listing of the foods that are most needed, and other information, is located here – please do read it through.
- We will accept food donations from anyone in the community, regardless of whether they are current clients – and if you just want to make a cash donation to help out, you can do so by
following this link. All are welcome!
- Clients with appointments falling during the drive are going to get a special opportunity
- For every 3 items you bring in during your scheduled visit, you get one entry into a drawing to win a WW Coastal Retreat!
- See flyer for details of retreat – and know some surprises are likely to be added as we get closer to the end of the contest
- Bring in as much as you’re able to give! No limit to how many items you can donate!
- Every three items garners you an entry into the contest, so 12 items = four entries…
- There are still some appointments available, so don’t hesitate to jump on the schedule if you’ve been putting it off. Yeah, we know how it goes. 😉
- If you have questions, Amanda Koennecke is your source – reach out to her at any time.
Let’s come together in community to help all of us be better nourished this year.
In good health,
Your Watershed Wellness practitioners
As spring comes into full bloom with the approach of May, people are flocking outside to run, jump, play… and get injured. Such is life! So now is the perfect time to discuss the most common varieties of common exercise-induced injuries: the sprain and its sibling the strain. When you pull a muscle or roll your ankle, it’s likely that you have sprained or strained something.
The broad definition of this painful condition is that you have stretched or torn a ligament (sprain) or a muscle or tendon (strain) without the joint popping out and becoming dislocated. Any time that something pulls or pushes on tissue with more force than it can resist, a sprain or strain is likely to occur.
Once a force is exerted on tissue and something tears, Qi and blood rush in to clear away the damaged tissues and bring nutrients in for the process of repair.
As this process gets under way, the area swells and will often become red, hot and painful. If the injury is severe enough, the joint may become too tender and swollen to bear weight or to use. Over a few days or weeks, the intensity of the repair process will decline, and so the swelling and pain will subside gradually until all is well again. This is the ideal circumstance, in which very little intervention from the outside is needed.
Unfortunately, this happy progression is not always what occurs.
One reason sprains and strains in the limbs are more often discussed is that the tendons and ligaments in our limbs don’t have excellent blood flow through them (fancy medical words: they are not well-vascularized). This means that the process of inflammation and repair has less resources to work with, a bit like the difference between a car crash in a city center and one in a remote area. The ambulance will get there as fast as it can in both cases, but it might be a while if you are far out in the wilderness.
The other tricky variable to consider in how quickly an injury will heal is the underlying physiology if the individual person. Here is a very zoomed-out overview of the organ systems that could be involved in healing a musculoskeletal injury from a Chinese medicine perspective:
- Liver feeds blood to the tendons and ligaments
- Spleen feed nutrients to muscles
- Lung ensures that Qi is circulated to the whole body
- Gallbladder moves fluid in the joint spaces
- Heart is in charge of moving and controlling blood in the whole body
- Sanjiao (Triple Burner) moves fluid in every space between organs and body cavities
- Kidney builds and maintains the bones
You can see that many organ systems are involved in the repair of injuries!
But which organs are impacted and to what degree is often best explained as an outgrowth of your constitutional tendencies. If you have digestive issues that your spleen is already dealing with, then its ability to repair your muscles will be compromised.
If you have liver Qi stagnation from a stressful job, the liver will have a harder time getting blood to the tendons or ligaments to repair them. When people are blood-deficient the liver doesn’t have much to work with in the first place.
“This is why treatment for an injury in Chinese Medicine is so individually tailored; it’s often a matter of treating underlying problems that are preventing the healing process from perfectly unfolding.”
What can you do the next time you roll your ankle or throw out your back?
Acupuncture, Chinese herbs, and especially topical herbs are very important for healing injuries quickly and completely. In addition, here are some home remedies based on prior imbalances that you can try out yourself:
- For Liver Qi stagnation (depression, stuck anger, frequent sighing, discomfort in the ribs): journaling, nature walks, talk therapy, exercise
- For blood deficiency (frequent waking from sleep, anxiety, abnormal-for-you pale complexion, forgetfulness) eating organ meats, leafy green veggies, possibly iron and b vitamin supplementation
- For Spleen Qi deficiency (fatigue, loose stools, feeling tired after meals, poor appetite) simple foods (grains, sweet potatoes, congee), regular meals (as in at a similar time every day), medicinal vinegars before meals (check out your local Asian market for delicious drinking vinegars), eating meals while focused on the food rather than in front of a screen or in the car.
- For Sanjiao stagnation (swollen lymph nodes, frequent itching of the skin, swollen and red areas in the neck and ears, chronic illness such as Lyme): proper hydration, gently detoxifying foods like citrus, fresh herbs, and burdock root
- For Kidney Qi or Yang deficiency (deep exhaustion, low back ache, chronic pain made worse by cold, frequent urination at night): rest, meditation, foods from the sea, quiet spaces, warm compresses
Have fun, take care, and drop us a line if you take a spill!
Watershed Wellness brings you a new series! You’ve received health care from our wonderful practitioners. Perhaps you’ve chatted with them for a quick minute before and after your appointment. But what is your practitioner like in everyday life? To help you on the path to knowing your practitioners better, we’ll start with a fun, informal interview. This quarter’s spotlight is on Rowan Everard, one of our brilliant Chinese Medicine practitioners. Rowan’s strong allegiance to queer/transgender care as well as a focus on chronic/acute pain management makes him a huge asset to both the Portland and Astoria clinics.
We sat down to chat about everything from music, to the kind of health care he admires, to what is so great about the Pacific Northwest!
- Thank you for sitting down to chat! Your patients and colleagues alike LOVE having you in this space. You’ve been at Watershed for over a year now, how’s that year been?
Yes! I feel excited to continue to grow my practice and my connections to the community of SE Portland. It’s been wonderful working with so many talented practitioners.
- What was the last awesome concert you went to?
- If money was no object, where would your next dream vacation be?
- What’s your favorite neighborhood in Portland and why?
North Portland/St John’s; it’s got such a lovely view of the hills and such good food.
- What’s in your Netflix queue right now?
The new Star Trek, of course.
- If you weren’t a healthcare practitioner, what would your next career choice be?
Probably an aid worker for the UN or Oxfam
- What do you love most about the Pacific Northwest?
That we have access to almost every kind of climate and topographic feature in this state; deserts, mountains, rivers and forests!
- Favorite cuisine?
Lately I’ve been really into Chinese street food.
- Out of the five basic natural elements (earth, air, fire, water, ether), which one do you identify with the most? As a practitioner of Chinese medicine, you’re required to answer this question! (Kidding, mostly).
- It’s your day off and you have no responsibilities. How are you spending your leisure day?
Hiking somewhere in the forest, most likely.
- Your top five favorite movies?
The Fountain, Shortbus, But I’m a Cheerleader, Fargo, and Bound.
- What’s your favorite season of the year?
- Which do you prefer, tea or coffee? Any favorite tea makers or coffee roasters?
Coffee. I’m partial to Equal Exchange because their business model is fantastic and their coffee is high quality.
- Would you rather read a book or listen to a podcast?
Listen to a podcast/book.
- What was your “aha!” moment that made you realize you wanted to be a healthcare professional?
I was imagining being a professor or working in an office somewhere. Then I realized that I would rather be working with people one on one than pushing papers around somewhere!
- Three words that describe your personality?
Empathetic, loyal, passionate.
- Where are you from originally, or where did you first call “home”?
The Chicago suburbs.
- What’s in your music queue right now?
- Where do you hope your practice lands in the next five years? What’s your biggest goal and hope with what you do?
I just want to help people heal and become the best physician I can be. Wherever that takes me, will be somewhere I’m excited to be.
- What is a health care modality that fascinates you, that you’d like to learn more about, or that you just greatly admire?
Functional neurology is super cool, and they seem to take a very Chinese Medicine approach to the body.
Stayed tuned for the next Practitioner Spotlight segment – coming in May!
Editor’s note: This interview was done by none other than Amanda Koennecke, despite the fact that Rowan is listed as the author. 🙂
One day as a medical intern during my schooling, a faculty member came in for a treatment for acute pain. He had just rolled his ankle outward, which is the harder and more painful way, and it was swollen almost to the same size as his knee. He wanted to know if I knew how to do acupuncture for acute pain, because he was leaving for a vacation the next day, and wanted relief! I said yes, and did what I considered to be a fairly simple acupuncture treatment to drain heat (inflammation) and move blood. We also applied a poultice of Chinese herbs guided by the same principles.
I’ve seen countless successes with acupuncture for acute pain since that time as an intern. Classical Chinese medicine, as I have written before, is designed to treat the most common maladies that people experience. However, because of the relatively recent introduction of Chinese medicine to the American system, combined with some structural problems in our healthcare system itself, means that people rarely consider an acupuncturist when they are injured. The way that injuries are approached from a Chinese medicine context is quite different from how they are approached in biomedicine (also called Western medicine).
Biomedicine, let’s be clear, is responsible for incredible recoveries – seeming miracles in many cases. For treatment of trauma, and enacting life saving measures in the face of poor prognosis, biomedicine is incredible. However, some have found that full treatment of those injuries to a pain free state, or overall treatment of chronic pain, seems not to be as well developed in this system. Could this be because the approach to acute injuries in biomedicine comes from work in extreme circumstances, such as battlefield medicine & high performance sports contexts?
If you consider this possibility, it does make sense, because people dealing with extreme circumstances tend to innovate and create useful technologies. Many pioneering approaches have come out of battlefield medicine, such as ready-made tourniquets and quick-clot. There is a dark side here, though: both sports and battlefield situations have different aims than regular civilian life. They both require people to be ready to exert themselves again as quickly as possible. This is not the same thing as healing an injury as fully as possible.
In fact, sometimes healing as quickly as possible can impede fullest recovery over the longer term
A simple illustration of this can be seen in the RICE protocol. RICE stands for rest, ice, compression and elevation. It has long been the standard approach to sprains and strains, and it comes from sports medicine. Icing an injury certainly does cause the swelling to go down. It allows someone to put weight on the joint again sooner, and get back on the field.
After the first day or two however, as the intense heat of swelling recedes, it begins to introduce cold in the site. Cold tends to slow biological activity, and can kill cells. From a perspective in Chinese medicine theory, cold injuries Yang, Qi and blood. In my clinical experience, and that of my teachers, this can lead to instability in the joint as it heals, and increased scar tissue. In extreme cases, it can an acute injury and creates a chronic one. Using acupuncture for acute pain – before it becomes a chronic condition – may be part of the answer!
How do acupuncturists look at acute injuries differently?
We’ll return to sprains in later posts, but for now let’s examine how Chinese medicine theory relates to acute injuries. There are various types of acute injuries, of course: breaks, cuts, punctures, dislocations, crush injuries, and endless variations and combinations of those types. From a CM perspective, what all of these types of injury share is that they cause Qi and blood stagnation. Wait – blood stagnation? You may wonder “how can a bleeding cut or similar be blood STAGNATION?” There’s a lot to say about that, but let’s summarize by saying that we define blood stagnation as any situation where blood is not flowing properly inside of the vessels. Being outside of the vessel, and pooling between layers of tissue, qualifies.
This becomes more clear if you imagine the process of wound healing with clotting, scabbing over and then scarring. Qi stagnation happens anytime that the body’s abilities to communicate is compromised, even at a cellular level. As cells are destroyed by an injury, dead zones of communication are created.
Stages of injury in Chinese medical theory
Acupuncturists treating acute pain recognize three stages that all acute injuries move through.
- Stage 1: The site of the injury becomes hot and swollen, and dead tissue builds up, which was think of as heat toxins. The body sends Qi and blood to the site to repair the damage.
- Stage 2: Some of the acute heat swelling recedes, and stagnation of Qi and blood due to tissue damage begins to create pockets of cold
- Stage 3: All acute heat and swelling are gone and only stagnation remains, largely as scar tissue, which leaves the area vulnerable to wind and cold becoming trapped.
Our acupuncture for acute pain treatment strategies flow naturally and rationally from these stages of healing.
- Stage 1: We drain heat toxins, stop bleeding and move Qi and blood
- Stage 2: Some draining and moving and some warming methods are used
- Stage 3: Warming and nourishing methods used, some moving Qi and blood but more gently
When treated properly with the above methods, injuries tend to resolve more completely. We accompany the patient through all of the stages of healing, giving them support every step of the way. This leads to a much more stable joint/limb/body cavity, with less scarring and often less pain. Simply put : acupuncture for acute pain helps avoid needing treatment for chronic pain down the road. While acupuncturists absolutely can, and do, treat old injuries – preventing them is much more satisfying.
What you can do on your own for acute injuries
You can always come see me if you get hurt, I specialize in acupuncture for acute pain! But, sometimes treatment isn’t feasible – or not feasible soon enough! In that case, here are some take-home strategies for self-treatment!
- Sanhuang San (pronounced Sahn Hwahng Sahn): known as herbal ice, this external herbal formula clears heat and moves Qi and blood, thus reducing swelling and pain. It works with the body to improve circulation, rather than shutting it down. You can mix the powdered herb with any ointment and apply thickly to the site of the injury, like icing on a cake. Do not use on open wounds! You can find the powder here, among other places.
- Warm/cool hydrotherapy: you can improve circulation in and out of the area by alternating warm and cool soaks or washcloths. Shoot for 10 minutes of one and 10 minutes of the other, for no more than an hour at a time. This will help flush toxins out of the area and then assist the body in bringing the circulation back.
- Don’t ice after the first two days! Really, please don’t. Use warm/cool hydrotherapy instead – protect that yang qi!
- Massage out bruises. Be gentle, of course, but from a Chinese medicine theory perspective, bruises are stagnant blood that needs to be broken up – moved. A little goes a long way here!
Use your injured body part gently and stretch. Circulation of Qi and blood is vital to the healing process, and needs to be balanced with rest. Listen to your body as you learn your limits during your healing process.
Have you ever tried acupuncture just after an injury or accident? If so – what was the result?
Last time, I shared some insights concerning “symptoms as messages,” a particularly unique way of approaching the body that the lens of East Asian medicine affords us. Today, I’ll share anotherpractical understanding that I apply in clinic during every single visit…
The teaching of the body and its restorative dynamics
“Restorative dynamics” is the teaching that reframes any and all pathology as the body’s positive effort establish equilibrium and deliver messages to the body. The teaching of restorative dynamics goes along with another saying from my lineage, which states that we are all simply and always “making contact to stay intact,” the two really help make sense of each other and cannot completely be understood one without the other.
Let’s start by exploring restorative dynamics
Symptoms, or pathology, basically what any patient “complains” of, can be seen through the lens of physiology. This means that the disease, complaint, or symptom is interpreted as something that the body was first trying to do to help itself. We see through the pathology into understanding the physiology that brought the symptom to bear. This logic extends that at one point or another what created the pathology was at some point, a physiological process.
For example, someone with an elevated heart rate may have just encountered a stressful influence. The person’s heart rate increases to afford the body extra circulation in case of the need to run or move quickly, defend itself, etc. After the stressor has left, gone away, been resolved, sometimes our heart rate stays elevated. This is because the body didn’t get the message that it was okay, to relax and slow the heart rate down again. So the body’s inherent wisdom can turn on itself, or get stymied in the process of trying to help us!
Doesn’t life feel like that sometimes? You just want to help yourself but you can’t?
Practitioners of Chinese medicine commonly understand pathology and disease as nothing more than life force attempting to express itself, and being stymied in that process. The theory behind restorative dynamics is that the body will not, for any reason whatsoever, produce a symptom (read: energy, personality, pathology) that has not served a purpose at some point in ones life. Further, any manifestation of pathology is one such dynamic that has, quite simply, outlived the circumstance in which it was called upon. This notion is predicated on the body’s inherent wisdom and the ecological approach.
A body (and necessarily a being) will do whatever it takes to maintain the integrity of the organism.
Here we bring in the saying that each human being is doing its best to maintain contact and stay intact.
This ‘making contact’ can occur at the level of interaction with another human being, or within the body as organ function, or on a grander, deeper scale where the individual tries to maintain relationship with life itself. Staying intact means doing anything that assists the being in a state of relative health and wellbeing, or, not obliterating itself. The idea of ‘making contact to stay intact’ speaks to personalities, attachment styles, and can even be translated directly to physical symptoms.
I have found that this is a concept that is easily thought of in a theoretical manner and often misunderstood or misappropriated when encountered in practice. This is not an easy teaching to put into practice, and often as human beings, and as practitioners we fall short, as we too, attempt to make contact and stay intact.
Making contact to stay intact means that every single action and interaction a person takes part in is their attempt at making contact (and staying intact) with their own experience, as well as maintaining relation to the world around them. Making contact means that each incarnate being wants to have connection, relationship, and interface with the world and the beings that make it up.
Staying intact means that as one makes contact, they do so to the degree that they are able to, based on that which holds them together, or makes them up. One of the first ways in which individuals manifest pathology is through personality; this is a very direct expression of energy. Chinese medicine is in the life, as Dr. Shen said; this means that every single movement, action, or thought a person makes is significant.
It is their attempt at maintaining contact with life and their attempt at living their life they best way they know how.
This means that when a person’s body produces an enormous rash that weeps copious amounts of pus and burns red, it is doing all that it can to make contact and stay intact. This also means that when a person enters into a deep depression wherein they are unable to talk to anyone, reach out to another human being, ask for help, or do much of anything – they too, are doing their best to make contact and stay intact. These manifestations are not limited to states that society commonly deems negative.
Alike, a person may encounter love, appreciation, and affection and react in a fearful manner. This is yet another example wherein the individual is attempting to make contact and stay intact. This tool gives us the opportunity to evaluate, or reevaluate, all of the times within our own lives wherein we interpret ourselves as misbehaving, doing wrong, making mistakes from this new lens of contact.
These two teachings are deeply expressed values of my clinical practice.
Is this a way you have thought about your body before? Does this feel new? Please write a comment below and let me know! And, as ever, if you would like to see how these principles integrate with the tools of classical Chinese medicine during an appointment with me, feel free to read more about my practice, and schedule online at any time. Thank you.
The clinic has been bustling with lots of healing here at Watershed Wellness.
It is incredible to watch people transform both inside and out. It has caused me joy and pause for reflection and consideration – why I do the work that I do? What are the most important things for me to return to day after day? What are the anchors of my clinical practice?
In my lineage there are many truisms, axioms, some would even call them mantras, that are repeated and repeated over and over to help us learn as students and ultimately clinicians. In fact, this is true for all of Chinese medicine (as well as specific lineages). I am devoting the next few blog posts to this; over the next few months I will share some of these axioms with you all, because they are a hallmark and provide insight into the way I approach treatment in clinic.
We’ll begin with an important one – “Symptoms as Messages”
I will devote the greater part of my entire life to considering the significance of the often repeated phrase that each symptom is a message. The teaching of symptoms as messages instills within each practitioner an ability to make contact with our own lives and the lives of our patients.
The examination of symptoms as messages affords us the opportunity to look at the truth of the body’s inherent nature – its rightful holistic and animistic place within the spectrum of “disease” and “health.”
This teaching of symptoms as messages is not only a profound shift in awareness for many; it disproves the objectification of the body so often clouding the consciousness of Western Culture.
No longer are ailments and dis-eases of the body separated from each of us as individuals, they are included and accounted for in lived experience. What I mean is, when we consider symptoms as messages we don’t objectify our very own bodies – saying, “Why is my body doing this to me?” As if the body is separate from ourselves?
Truly wrestling with the implications and influence of this teaching has changed my practice over the years. I used to think that it meant that every symptom was trying to tell us something about the person – or that it was speaking about the energetic to physical continuum of disease – and that was it!
Reflection on the teaching of symptoms as messages points us toward increasing our proficiency in the language that the body speaks to us.
Symptoms are the body’s language. Rather than simply looking toward the manifestation of pathology as something that the body is doing to us – or further, doing incorrectly – when we understand symptoms as messages we assume the inherent healing capacity within the body for health and healing and from there, seek to understand, to uncover the root of the symptom.
As clinicians, this is imperative! Otherwise we are only treating symptoms! And who wants that? Treating only symptoms goes against the core directive of Chinese medicine which is to treat not only branch (symptom) but the root (etiology) of disease. Often times this leads us back to a specific moment wherein a physiological process was stymied or obstructed.
The body, by producing a symptom, says, “look here” and points in the direction of the impeded dynamic.
For example, a patient has a phlegmy cough that is copious and productive – the body in its inherent wisdom, points us toward the lungs. You’re thinking, of course, but here is where it gets exciting. Instead of trying to cool or disinhibit the lung from coughing, we instead are going to seek to understand the dynamic that created the cough in the first place.
In this way, as practitioners we walk ourselves through the symptom; to be able to perceive the restorative dynamic that underlies the “pathological” manifestation. We then see through pathology into physiology and perceive clearly how to meet the patient where they are.
Our patients come to us; we come to each other, perfectly, in our states of dis-ease.
It is not our charge as Chinese medical practitioners to fix anything, but to engender the already inherent capacity of the body and of the vital force of life. This is how we fulfill our oath as practitioners, when we pledge that we will be “devoted to the task of saving the sacred spark of life in every creature that still carries it.”
It is from the body’s resolute determination and movement toward health and ontological expression that any symptom manifests.
These points of contact, these expressions, are where the body speaks to us, in symptoms as messages. I would love to hear your thoughts after reading this – does this resonate with how you look at your body, or this is a new perspective?
Please let me know if you have questions or responses to this post, or if you are interested in working together in clinic and have questions, do not hesitate to reach out.
It’s a dilemma that trans-masculine people know all too well: the need to reduce the painful experience of dysphoria on the one hand, and concerns about longterm health on the other. At first, the decision is easy; we strap down our breast tissue somehow some way, whether with ace bangs, commercially-made binders or compression shirts. The internal alarm bell that goes off when we look into the mirror or down at ourselves quiets, and we finally get some relief. All seems well for weeks, maybe months.
Unavoidably though, a new problem arises: pain.
Where the pain resides exactly depends on the person and the binding method, but it will arise. Compression of our rib case, and the soft tissues beneath, can lead to a wide variety of problems. Rib pain, shortness of breath, dizziness, and even scary chest pain can all becomes staples of daily life during binding.
Let’s examine how to think about this situation using the tools & science of Chinese Medicine. In this way of thinking, the trunk of the body is divided into three compartments, or Jiao. The upper Jiao contains the lungs, heart and pericardium. The middle houses in the liver, gallbladder, stomach and spleen, while the lower is the home of the kidney, bladder and both intestines. The final organ, the Sanjiao or Triple Burner, is a network of water passages that connects all three for the purposes of transport and communication.
In addition to the organs, we also have meridians or Chanels associated with each organs, as well as larger channels that connect all twelve.
The most-often-used metaphor for this system is a watershed that runs through the deepest parts of our bodies, which then consolidates and emerges into broad rivers between the muscles and fascia, finally concluding as small streams at our surface. What a nice metaphor – and it has broad utility. This network, according to Chinese medical theory, carries information, regulates water metabolism, and ensures that homeostasis (the balance inside our body that enables health) is maintained by subtly responding to all of the weird things that happen us throughout our lives.
Given this system’s intricate levels of communication through different kinds of tissues, imagine what might happen if we took the entire thing in the upper and middle Jiao, and squeezed. Not just once, but constantly, every day, during every waking hour and sometimes sleeping hours as well. One can imagine that all sorts of processes could be negatively impacted!
Here are a few of the potential consequences, on this view:
Blood flow: blood is hugely important process that our bodies use to transport nutrients, gasses and yang (life force) from place to place, and its functions are especially associated with the heart, pericardium and liver. If blood flow is impeded, these organs can become either too full of blood (stagnation) or have their blood supply be subtly reduced (deficiency).
Symptoms can include chest pain, pain in the ribs and abdomen, anxiety and depression.
Water metabolism: The spleen, lung and kidney are all important organs that ensure the proper flow of moisture around the body. The kidney is said to seam water up into the upper Jiao, the spleen to transform and transport it from food and drink into the other organs, and the lung to accumulate moisture and then rain it back down to the rest of the body. If the lung becomes physically compressed, moisture can accumulate and build up as phlegm.
Over time, the heat of the body can cook this immobilized phlegm into a hot goo that results in chronic congestion, hot chest pain, cough and anxiety.
Qi transformation: the work of the organs is done around the body by their associated channels, through a process called Qi Hua or Qi transformation. To give one example; the stomach channel carries the hot and drying Qi of the stomach organ up the front of the body to assist with digestion, heat distribution and immune functions.
Cutting down the size of its pathway through the chest can impede its flow, resulting in stomach organ issues like reflux, nausea or vomiting. It can also have implications for our immune systems.
All of the issues that can arise from binding can be treated through acupuncture, herbs, bodywork, and targeted exercise, but their cause is the practice itself. I want to be careful here not to engage in victim-blaming. Many healthcare providers think about this issue and say “yes, my patients should certainly stop binding if it’s causing so many problems!” But that ignores the entire reason that we do it in the first place. Dysphoria is a very real health problem with severe mental health implications.
Binding is often a life-saving act of harm reduction that allows us to life our lives without the constant mental anguish that dysphoria creates.
Surveys of people who bind find that the vast majority of people are doing it while they await the ability to access a surgical solution. Until very recently, top surgery was not covered by insurance and was only available to those who could pay out of pocket. This has begun to change in some states, but remains the case for most people. Therefore we should remember that binding is a self-preserving response to a societally-imposed scarcity of medically-necessary healthcare.
While we engage in the activism needed to change this, here are some harm reduction strategies to consider:
- Stretch it out: engage in stretching poses that open the chest and ribs, for at least five minutes a day
- Build strength: strengthening the muscles of the back and chest may help hold the body of your ribcage in place and protect them from the longterm effects of compression
- Move your body: qi and blood move when we do, and exercise of any kind helps prevent stagnation. Depending on how you bind, running may not be a great plan, but walking is wonderful for both our bodies and our moods.
- Get some acupuncture: we can reduce stagnation and pain by unblocking channels and moving qi and blood in targeted ways
- Take some herbs: chest stagnation and digestive issue in particular respond well to Chinese herbals formulas
- Listen to your body: only you can know what is right for you in terms of when to bind, how to move, and how to balance all of the considerations in your life.
Above all, be gentle with yourself as you navigate the complexities of trans experience. If you want support in your journey, schedule an appointment and let’s see how we can work together.
As a complete medical system in and of itself, Classical Chinese Medicine (CCM) inherently focuses on the person we are treating and not their “disease.” Any practitioner of CCM will tell you, “I don’t treat diseases; I treat people.” This is a medicine of pattern and number, it teaches one to see, to perceive, and heal in this same way.
Patterns are incredibly useful in medicine.
They allow us to differentiate, specify, and treat the person sitting in front of us. Over and over I have seen how this distinction is essential in clinical practice. You can treat someone regularly, daily even, for the signs and symptoms they present but in order to make lasting change we seek to treat the root and the origin of the symptoms themselves. Medicine is not “one stop shopping” and there is not “one cure” to disease. The root of a disease in my body will likely be different than the root of a disease in yours.
Chinese medicine itself is multivalent.
All at once, simultaneously, it accepts many truths, interpretations, and meanings. This can be disorienting to the more commonly western bivalent experience where having one thing excludes another, where we either “have” a disease or ailment or “don’t have it.” CCM theory holds within it multiple truths at the same time. This is something that teaches us not only about medicine, but also about life – about experience.
There is always more than one truth existent at the very same time that other truths are present.
I have recently journeyed into some easily accessible patterns throughout the discussions of the archetypes with specific reference to women’s health, the maiden, the mother, the crone. Today, I’d like to continue this journey, but with a different pattern, blood deficiency. Blood deficiency is a differentiation often discussed in women’s health as it is something that happens quite ubiquitously; it is often one of the root patterns we are addressing in treatment.
Blood deficiency does not mean that one person has less blood volume than another.
And yet, it could come about from someone having experienced a trauma where they indeed lost a lot of blood; folks like this present with blood deficient signs and symptoms. In Chinese medicine blood deficiency can also be created over time. Deficiency can manifest from not only frank blood loss, but more commonly, from stagnation that has created something that looks like deficiency because resources are stuck elsewhere.
When the etiology is loss of blood it can arise from childbirth, hemorrhaging due to trauma, surgery, etc. When the etiology is a more gradual depletion it can come from heat and stagnation, either from internal causes (the suppression or repression of emotions) or external causes for example lack of movement or sitting for many hours.
The qi moves the blood; anything that disrupts the circulation of qi can lead to blood deficiency.
My teacher’s teacher, Dr. Leon Hammer, has an oft-quoted phrase, “the blood is the repository for the softer emotions.” When we have the experience of plentiful nourishing blood perfuse our bodies, we experience easier access to softer emotions and flexibility both with ourselves and with others.
Symptoms associated with blood deficiency are irritability, insomnia, anxiety, poor memory, dizziness, pale complexion, and fatigue.
Blood deficiency can also co-exist with symptoms such as poor digestion, constipation, nausea, and headaches. Again, these are general signs and symptoms. In fact, this type of association as a one to one correlate is contradictory to the core of our medicine. We care most about what is happening for each individual person in the very moment they find themselves in our treatment room.
Pulse diagnosis is a very useful tool both for diagnosis and for directing treatment.
I rely on the pulse in clinical practice to help me differentiate where the deficiency is coming from in the specific person I am working with. The width of the pulse will help me learn whether or not there is blood deficiency. The corresponding qualities will help me determine whence the blood deficiency comes. Is it from a frank deficiency or stagnation? Is the pulse Thin and Deep, Thin and Yielding, or Thin and Tight?
When we talk about blood deficiency we are often talking about liver blood deficiency, as the liver stores the blood, but equally, we could also be talking about the relationship of blood within the heart, or spleen, or other organ systems for that matter! This is where the specific pattern differentiation comes in. Curious about how the Chinese medicine blood deficiency pattern might manifest for you?