Chinese Medicine Psychology - A Clinical Guide to Mental and Emotional Wellness

'The authors provide a clear and full depiction of psychological terms and concepts of traditional Chinese Medicine (TCM). They also meld classical and contemporary data to present a clear manual for TCM psychology. The introduction of multiple TCM therapies for mental and emotional diseases will be of great benefit for all TCM practitioners and patients in today's society.'
- Zhang-Jin Zhang, BMed, MMed, PhD, Professor, Associate Director (Clinic), School of Chinese Medicine LKS Faculty of Medicine, The University of Hong Kong

'With the increase in the prevalence of mental health issues globally the need for a better understanding of treatment options is now even more imperative. Qu and Garvey explore the classical Chinese medicine wisdom of this rich knowledge area. Drawing from case studies using formulas from the Essential Prescriptions of the Golden Cabinet they weave a clinical narrative that continues to be relevant today.'
- Christopher Zaslawski, Associate Professor, Head - Chinese Medicine Discipline, School of Life Sciences, University of Technology Sydney

'In part one of their book, Professor Qu and Doctor Garvey have done an admirable job of providing the context needed to merge the Chinese philosophy of Shen with modern psychology. Part two is filled with sound herbal advice. Keep it on your shelf as a reference, but first enjoy it with a cup of tea and a few hours of self-reflection.'
- Yvonne R. Farrell, DAOM, LAc

'Chinese Medicine Psychology provides a nice concise survey and elucidation of the Classical Chinese understanding of psychological disorders. Part 1 discusses medical principles underlying the shén, its formation, manifestations, roles, functions, and maintenance. Part 2 ties in the classical disease patterns from the Golden Cabinet with representative formulas. Pathomechanisms and etiologies are likewise discussed and modifications are provided. Case studies providing anecdotal real-life formulae round out the text. A excellent reference for students and practitioners alike.'
- Ross Rosen, author Heart Shock: Diagnosis and Treatment of Trauma with Shen-Hammer and Classical Chinese Medicine, 23rd and 25th gen. Quanzhen Longmen Daoist Priest

'Chinese Medicine Psychology is destined to be one of the definitive texts in the field for the diagnosis and treatment of emotional and psychological disorders. Several chapters in part one carefully delineate core concepts from the Su Wen, Ling Shu, Nan Jing, Jin Gui Yao Lue and the work of Zhang Jing-yue (as recorded in the Lei Jing/Categorized Classic). The second part of the book builds on this understanding to explain the foundations of how classical Chinese medicine views essential aspects of human life, mind, and the emotions. In part three, clinical applications are presented built on material and formulas from Zhang Zhong-jing's Jin gui yao lue/Prescriptions from the Golden Cabinet, with case histories. As culture is a major influence on psychology, the authors also compare Chinese and Western approaches to psychology, noting similarities and differences. I highly recommend this text for all practitioners, as xin li xue/psychology is an essential subject that demands clear explanation of terminology, concepts, diagnostics and/or overlays of Western views of the mind and psyche.'
- Z’ev Rosenberg, L. Ac.

 

Review from JCM 123 (June 2020)

When I was offered to review Chinese Medicine Psychology by Professor Qu Lifang and Dr. Mary Garvey I had little doubt about whether to agree: mental-emotional issues are my ‘field’ and I had read some of the authors’ articles and found their work to be built on solid foundations and a source of great interest. While going through the book I was thoroughly engaged, and after having read it I can say that there are very good reasons to give it our attention.

The text is organised in two well-defined parts: the first section discusses Chinese medicine’s theories of the mind and emotions, and compares them with Western psychology. The second is about diagnosis and treatment, with a clear discussion of the main classical formulas for psycho-emotional disorders. The first joy to notice was the precision and care for terminology. With Qu and Garvey there is no risk of drifting around vaguely: the choice to use both pinyin and Chinese characters, the explanation of a character’s use in the medical classics, the accuracy of the quotations and the comprehensive glossary all showed the scholarship and care put into this text. 

The authors acknowledge from the first page the complexity of their subject, saying that: ‘神 shén has accumulated various connotations over thousands of years, and its meaning can change according to its context in philosophical and religious texts, cultural traditions and common language’ (p. 17). To discuss the notion of ‘mind’ they take into account the early Chinese worldview through texts like the Daodejing and the Yijing, proceeding with the Confucian master Xunzi, to the medical text Neijing. As an aside, I found the choice of presenting the well-known classics with their translated title peculiar (e.g. Classic of the Law and Its Power instead of Daodejing); just as shén is not translated because it does not have a clear correspondence in Western language, so any translation of these titles seems to require explanation, since it is not the only possible choice.

Their perspective is rich and dynamic: they identify a transcendent dào without space and time and a contingent world of yin-yang and shapes; they highlight how yin-yang represents natural law and is the framework used by ‘proto-scientific traditions, including Chinese medicine’ to study what has substance and shape; they distinguish běn néng (‘unlearned biological functions and capabilities’) and běn shén (‘the innate nature of our shén-spirit/mind, our human qualities, character, behavior and personality traits’); they recognise the different uses of 心xīn, 神shén and 志qíng in medical literature and the multifaceted meaning of zhì; and they mention the use of a traditional ‘so-called talking cure’, with reference to some well-known cases in the last chapter. 

From this basis and referring specifically to Suwen chapter 70, the authors develop a discourse around the three concepts of ‘inner root’ (中根 zhōng gēn), ‘shén dynamic’ (神机 shén jī) and ‘qi set-up’ (气立 qì lì). They put forward that the ‘inner root’ of living creatures is ‘shén dynamic’, while externally ‘the movements of nature’ are based on ‘qì set-up’. The ‘inner root’ of sentient beings, the ‘shén dynamic’, stored in the five zàng, is the ‘generative qi’ (生气 shēng qì) and determines life and death, the trend of pathological changes (and thus prognosis), and has processes similar to metabolism, with construction and destruction, anabolism and catabolism.

The discourse unfolds then into the idea that ‘every human life has three aspects of shén’ (p. 53), which are the ‘root and source of the shén’ (本神 běn shén), the ‘initiating shén’ (元神 yuán shén) andthe ‘acquired shén’ (识神 shí shén). This framework is taken for granted, although in the following chapters they specify that the Inner Canon does not differentiate these three aspects or explain their interpretation. They describe ‘root shén’ (本神) as being synonymous with the ‘source shén’ 原神 yuán shén) and specify that Explaining and Analysing Characters (the great Shuowen, the first dictionary, dated 121 CE) explains the character 源 yuán-source as ‘root of water’, ‘root source of the source, which takes a very long time to accumulate’ and ‘the underground source of spring water is the one hundred sources’. They point out that the three drops in the pictograph depict water emerging from deep within the core of a mountain - one of the many descriptions of ideograms and pictograms in this text that are so evocative of the deeper meaning of the terms elucidated.

The ‘initiating shén’is generated by the ‘root shén’or ‘source shén’ through the meeting of the parental jīng-essences. They offer here a useful discussion of the two yuán, 原 and 元, saying that the meanings of 原 yuán-source and 元 yuán-origin/initiating are similar and many authors today treat them as synonymous. However, 原 yuán-source is like ‘a spring that gushes out from a hill’ so is closer to the idea of 本 běn-root; whereas 元 yuán shows the germination of a seed and thus indicates beginning action or initiating something. The ‘initiating shén’ drives basic functions such as the heartbeat, breathing, eating and sleeping, and instigates the different stages of human growth, development and reproduction. Qu and Garvey make an interesting argument regarding ‘initiating shén’ and the concept of ‘pre-natal’ (the time before birth or conception): they consider the ‘root shén’as the ‘prenatal [part of the] prenatal’ shén and ‘initiating shén’ as the ‘prenatal postnatal’ shén, that is, the shén that operates between conception and birth. Their attempt to overlap different paradigms of reference in their explanation is intriguing, for example when they say that ‘the Golden Flower said that the initiating shén resides in the square inch between and behind the eyes, and later, Lǐ Shízhēn (1518–1593) confirmed that the initiating shén resides in the brain. […] In Chinese psychological thought, the adrenal response is an example of root and initiating shén responses at the level of the kidney-lifegate (lodging the source 原 yuán) and brain (lodging the origin 元 yuán). […] The initiating shén quickly converts root shén experiences and abilities and transfers them to the postnatal life situation. Today we call these the adrenal response.’ (p. 61). Finally, the ‘acquired shén’ (识神 shí shén) is based on the initiating and root shén and is ‘the heart-shén’s recognition, understanding and acquisition of knowledge and skills […] its ‘acquired’ nature is moulded by the subtle, severe, gradual and sudden influences and experiences of our postnatal life.’ They also state that the ‘acquired shén’ is the ‘observable, conscious level of the mind’.

In the next chapters we find an overview of the theories of mind and emotions in the classics, including the activities of the five shén. The discussion is never superficial, so that for instance we read that, ‘the combined functions of the heart-shén, spleen-yì and kidney-zhì contribute to awareness and memory — the shén for reception and analysis, the yì to assist processing, and the zhì for storage. The creation and storage of memories are cared for by the three zàng most closely associated with the three treasures (精气神 jīng qì shén) and our ancestral resources.’ (p. 80) Likewise, I appreciated the overview of the five emotions, taking into account their relationship with qi movement (ascending, slowing, weakening, etc.). This first section also includes chapters on constitution, possession and hallucinations, dreams, shén brightness (神明 shén míng) and cultivating life (养生 yǎng shēng). 

The second part of the book, devoted to diagnosis and treatment, is based on the idea that rather than treating a physical or psychological disease, the approach should be to adjust and harmonise qi influences, movements and transformations. Qu and Garvey understand how Chinese medicine’s earliest examples of what we today know as psychological disorders were first recorded by Zhāng Zhòngjǐng (150–219 CE) and use his Golden Cabinet (Jīn Guì Yào Lüè as the main reference together with classical formulas from Zhāng Jièbīn and others. They organise the material, starting from early categories of illness, as follows: shén–hún disharmony, shén–pò disharmony, hún–pò wandering, shén wandering, Lily bulb disease,‘visceral agitation’ (脏躁 zàng zào), depletion-taxation and constraint syndrome. Their proposals of classical formulas are well explained and differentiated. More formulas are described in the following section, which takes into account contemporary disease categories, such as depression, gynaecological pain, post-partum psychosis, insomnia, anxiety and dementia. Acupuncture is mentioned briefly as a list of points in an appendix. The clinical part of the book is well organised and useful: there is attention to complexity and at the same time a simple approach to the formulas, which are clearly grouped, compared and analysed.

In my opinion, if a book leads to discussion it means it is worthwhile reading. This book has a slim but very dense body and mind, and for those with a clinical interest in psychological disorders, it is good to keep near!

Elisa Rossi