Edificatory speech therapy is a kind of psychotherapy that uses the language to talk about the patient’s condition and its psychological state, affective disorder, etc. ,to eliminate the cause of the disease and correct its adverse emotions and emotional activities. Spiritual Pivot: Instructions of the Teacher points out: “It is human to dislike death and prefer living. The doctor should tell the patients what are harmful to their health, let them know what are good for their health, guide them to do what they like for storing their health and try to straighten them out of their anxiety. If the doctor has done all that is required, even a most unreasonable person will follow his advice. “The treatment and mechanisms of this therapy are explained in principle.
The therapy can be traced back to the ancient times. Plain Questions: Discourse on Moving the Essence and Changing he Qi says: “When the people in antiquity treated a disease, they simply moved the essence and changed the Qi. They were able to invoke the origin and any disease came to an end. “It is a psychotherapy “to invoke origin without need of needles and pointed stones” (Wang Bing’s notes). As for invoking origin, Spiritual Pivot: Thief- like Wind interprets it as “Sorcerers in ancient times knew the causes and treatments of diseases. What they usually did was to find out the cause of a disease first and then treated it by prayers.” Zhang Jingyue, a doctor of Ming Dynasty, believes that invoking origin is a special treatment with conversation and different from the superstition of the spell. lt works through the doctor’s “searching for the cause of the disease and releasing the ‘ghost’ in heart”. The common methods include “guidance and persuasion”, “disambiguation and distinguishing right”, and so on. Since Tang Dynasty, there are departments of invoking origin set up in many hospitals in the past and there are medical officers in charge. Invoking origin is similar to modern psychotherapy if some of its superstitious elements and mysterious colors are removed. Therefore, Edificatory Speech therapy has important clinical value.
Basic Contents
Language conversation is not only the main emotional medium for communication between people, but also the basic way to understand and master the psychological and emotional activities of patients, and the basic premise of applying edificatory speech. Spiritual Pivot: Qualifications of Acupuncturists says: “People with eloquence can be assigned the duty of discussing theory. “The so-called “eloquence” refers to the ability to express. Psychotherapists, especially those with the use of this therapy and the ability, must master the theory of TCM and psychological and behavioral analysis methods in order to adopt appropriate conversation methods and techniques based on the patient’s temperament type and psychological and emotional disorders. Through the analysis of the disease, they tell patients the causes, consequences and harm of the disease, persuade patients to correct bad habits, eliminate the fear, pessimism, depression and other moods that hinder rehabilitation, and guide patients to rationally choose the good rehabilitation method to the body and mind, so as to obtain a satisfactory psychological treatment. This is the basic spirit of “tell”, “let them know”, “guide” and “straighten” elaborated in Spiritual Pivot: Instructions of the Teacher, and also the main principle and method used in the application of the edificatory speech therapy.
In the clinical diagnosis and treatment process, the patient’s physical conditions and temperament type should be observed and analyzed first. Qi Shi, a doctor of Ming Dynasty, points out in Primary Mirror of Rectifying Deficiency: “The human endowments are different and the causes of diseases are different. “The endowment he mentions mainly refers to the individual temperament characteristics of the patient, emphasizing the different susceptibility of people with different physical conditions and temperament types. TCM attaches great importance to different types of personality psychological characteristics (including emotion, personality, will, ability, etc.) and their relationship with disease. Since Internal Classic, there has been complete and systematic discussion of the classification of individual physical and mental characteristics. For example, Spiritual Pivot: Correspondence between Man and Nature divides the crowd into five types: greater Yang, lesser Yang, greater Yin, lesser Yin as well as balanced Yin and Yang, according to the quantity of Yin and Yang. Spiritual Pivot: Twenty-five Types of People Divided According to Yin and Yang summarizes the physical and mental characteristics of metal, wood, water, fire and earth people from the perspective of five phases. Based on this and together with predominance of five phases, it subdivides into twenty-five sub-types, and describes in detail the emotional, cognitional, will, behavioral and other psychological characteristics and physical features such as head, limbs, trunk, skin color, sound, etc., as well as even the susceptible diseases, timing, pathogenesis, treatment and other clinical characteristics of various types of people. For example, greater Yang (fire) people generally show small head, thin cheek, full shoulder and red complexion. Their behaviors are often expressed as self-use, quick and decisive, sometimes putting into action without consideration, often revealing a self-satisfied or arrogant attitude, which reflects impatience, impulsiveness, self-esteem and other extroversion characteristics of greater Yang (fire)people. The physical appearance, demeanor and behavior of greater Yin (water) people are generally humble, introversive, considerate, determined before action, even deceptive and other introverted psychological characteristics (table 2-1).These discourses of Internal Classic have become the main basis for future generations of doctors to conduct psychological and behavioral analysis of patients and to guide the clinical use of edificatory speech therapy.
The patient’s emotional extremes can also be caused by malignant stimulation of factors such as the situation, and become one of the original causes of many internal injuries. Therefore, it is the key to the effectiveness of this therapy to examine the patient’s emotional changes and enlighten him according to his temperament. The doctors of previous generations repeatedly state that the patient’s onset of the disease must be carefully consulted before comprehensively understanding his social experiences, living habits, hobbies, personnel changes, etc. and grasping his emotional activities such as joy, anger, sorrow and happiness. It is “to find out the cause of a disease first” and then dispel the cause of the disease and relieve his mental burden. For many patients, Primary Mirror of Rectifying Deficiency points out: “those of temperamental predominance and unable to balance their spirits should be treated their temperament; those of immoderate lust should control desire to nourish essence; those stagnant in mood should control annoyance to nourish spirit; those irritating and unreasonable should control anger to nourish liver; those impetuous should control hard work to nourish strength; those thoughtful should control thought to nourish heart; those compassionate should control sorrow to nourish lung. “Therefore, for the treatment, the doctor should fully exert his influence on the patient and play the role of Edificatory speech therapy. “Alert of life and death” or “right with morality and justice” or “guide be free and easy” or clear up doubts or remove the wild fancy or tell bluntly or reason allegorically, so as to “debind and open the glue “to relieve the patient’s mental and physical pains. For doctors, when applying these methods, only when “diseases met the right doctor can the affect between them be achieved and the diseases be cured”. (Classified Classic) It is difficult to work if the affect between doctors and patients cannot be achieved. Therefore, Zhang Jiebin emphasizes that “discipline being not strict cannot suppress the desire; speeches being not sincere cannot change the spirit”. These principles and treatments elaborated by the ancient physicians have general guiding significance for the clinical application of this therapy.
| Table 2-1 Classification Table of Physical and Mental Characteristics in Internal Classic | ||||||
| Characteristics | Category | |||||
| people with greater Yang (fire) | people with lesser Yang (metal) | people with balanced Yin and Yang (earth) | people with lesser Yin (wood) | people with greater Yin (water) | ||
| Physiological characteristics | exuberance of Yang with decline of Yin | exuberance of Yang with lesser Yin | balanced Yin and Yang | exuberance of Yin with lesser Yang | exuberance of Yin with decline of Yang | |
| Psychological characteristics | Emotion | impatient, impulsive, good at resolving sorrows and worries, optimistic and open- minded, comfortable and self-satisfied | impatient, firm and refreshing, vain | frank, peaceful, happy and cheerful, fearless | introverted, silent, sentimental, jealous | introverted, self-abased, or stubborn, or deceptive, or emotionless, or quiet as water, indifferent |
| Cognition | good at observation and thinking, quick at response, conclusive only based on the superficial phenomenon, superficial in understanding | in-depth and prudent in observing and understanding objective things, clear about what is right and wrong, of management skills, arrogant | obedient to the law of the development, grasping the essence, able to adapt to the situation, of high level. of understanding and management skills | scheming, diligent in thinking, smart and intelligent, of high level of cognition and the ability to engage in mental work | not readily publishing and changing own ideas, good at listening to other people’s opinions, slow in cognitive speed but high in cognitive quality, profound scrutiny of problems | |
| Will | emulative, self-willed, bold, rash, no regret even if failure, unrealistic, starting without end | firm, not dependent on people, of strong self-control and will | strong-willed, independent, dedicated, not afraid of hardships, not self-willed, sometimes flexible and following | indecisive in will, easy going, or concessive, or idle, or enterprising in career | weak in will, taking action following the actions of most people on the basis of repeated thoughts | |
| Behavior | treating people honestly, good at socializing will to make friends, paying a little attention to money; rude in behavior, impulsive, flatulent, gassy, lack of credit; adapting to the surrounding environment quickly | good at diplomacy, entertainment 1 and social activities; honest and fair, serious and cold, smart and capable; self-promoting and arrogant after a small promotion | honest, modest and courteous, helpful, generous, calm, and disciplined; serving people with morality,. not favoring power, not changing with their status, and treating others with a gentleman’s attitude | taking care of every single thing personally, lacking trust in others, lacking compassion, or greedy, harming others to benefit himself; weak in physical strength, or lazy | treating people humbly in appearance, but having a sinister heart; greedy in money; deceptive, even attaining his end by hook by crook | |
| Body shape | red complexion, thin cheeks, small head, well proportioned shoulders, back and abdomen, full muscles, small hands and feet | white complexion, small head and square face, small hands, feet, shoulders, back and abdomen, light and thin body, strong heel | yellow complexion, big head. and round face, well- featured, full and strong shoulders and back, slightly large abdomen, slightly small hands and feet, plump and symmetrical whole body | slightly green skin, small head and long face, wide and thick shoulders and back, straight upper body, small hands and feet | black skin, wrinkled and not flat face, large head, like monkey cheek, narrow shoulders, large abdomen, long spine and back | |
| Posture | the: whole-body swaying. when walking, fast pace of walking, sometimes convex chest and belly, with an arrogant attitude | the body swinging when walking, brisk and agile when standing, the head raising high and the hands being back contentedly | stable when walk, dignified and generous, peaceful and measured when behaving | self-contained in appearance, not generous in behavior not stable enough when standing, or the hands and feet being restless, walking like a sickle, difficult to straighten, or as if trying to hurt other people secretly | drooping eyes, seemingly humble; large body, but often with a cringing attitude; when walking, the body swinging, and the hands and feet moving | |
| Clinical Characteristics | Susceptible diseases | Adapted to spring and summer, not suitable for cold season as autumn and winter; autumn and winter are susceptible to external evil and being sick | Adapted to autumn and winter, not suitable for warm and hot season as spring and summer; spring and summer are susceptible to evil and being sick | Adapted to autumn and winter, not suitable for spring and summer; spring and summer are susceptible to external evil and being sick | Adapted to spring and summer, not suitable for cold season as autumn and winter; autumn and winter are susceptible to evil and being sick | Adapted to autumn and winter, not suitable for warm and hot season as spring and summer, spring and summer are. susceptible to. external evil and being sick |
| Key points of pattern and treatment | For people with exuberance of Yang with decline of Yin, the treatment should be adjustment of Yin and Yang. Yin could not be wearied on and Yang. could only be drained slightly. Major drainage and desertion of Yang Qi are prone to mania. Desertion of both Yin and Yang is prone to sudden death or unconsciousness. | For people with exuberance. Of Yang, with lesser Yin, small channel and big network, as well as Yin blood inside and Yang Qi outside are their basic pathogenesis characteristics The treatment should be repletion of Yin channel and drainage of Yang network. Excessive drainage of Yang Qi is prone to insufficiency of center Qi or various patterns of Qi desertion. | For people with balanced yin and Yang and smooth blood and vessel, superabundance or insufficiency of Yin, Yang, Qi and blood should be carefully diagnosed. Drain the superabundance while supplement the insufficiency Treat the same channel if without superabundance and insufficiency. | People: with exuberance of Yin with lesser Yang and small stomach and large intestines are susceptible to disharmony of six bowels, leading to small yang brightnesses wile large hand greater Yang vessels. Their scant Yyang Qi failing to contain blood is prone to Yin blood desertion and debilitated Yang Qi. When treating, diagnose dearly and adjust Qi and blood carefully. | For people with exuberance of Yin with decline of Yang, exuberance of Yin causes. thick and turbid blood while decline of Qi causes stoppage of defense Qi. Yin and’ Yang are imbalanced. Their skins are thick. Their sinews and vessels are flaccid The treatment should be quick drainage f Yin turbidity and removal of disease Qi.” | |
| Note: This table is organized according to two chapters of Spiritual Pivot: twenty-five Types of People Divided According to Yin and Yang and Correspondence between Man and Nature. | ||||||
Clinical Application
Broadly speaking, in the process of diagnosis and treatment of diseases, clinicians consciously or unconsciously use the speech-guided therapy to guide and unblock the psychological and emotional disorders of patients, so as to relieve their doubts and worries, dispel emotional factors that cause diseases, as well as to help patients treat diseases correctly and develop reasonable living habits. Therefore, as the most widely used psychological treatment method in clinical practice, it is of great significance for the treatment of various diseases. As far as the characteristics of this therapy are concerned, it has an irreplaceable therapeutic effect on psychogenic and emotional disorders associated with psychogenicity, situational diseases and other diseases.
For some patients due to doubts, they should be diagnosed and treated according to their pathogenic causes in order to recover without medical help. For example, mistaking the shadow of a bow in one’s cup as a snake, a case described in The Book of Jin: Biography of Yue Guang is one of the examples of the ancients applying this therapy. He Jie is invited by Yue Guang to have food and drink. After a few cups of wine, he suddenly sees a small snake at the bottom of the cup and feels a foreign body in the throat. Thereafter, doubts of the small snake eating his viscera cause worse and worse heartache. It is not effective to invite doctors or take medicines. Later, Yue Guang asks the cause and is told what has happened. Yue Guang looks around again and sees a snake-like bow hanging on the wall, which means the snake in the cup is the shadow of the bow. Yue sets the cup on the original place and asks He Jie if there is a snake in the cup? He Jie answers yes. Yue Guang “tells him why before He Jie suddenly understands it and his severe illness recovers immediately”. The heartache of the case is caused by the doubt of a small snake in the cup. The doctor and the medicine are ineffective. Finally, the facts are told to enlighten. The doubts are dispelled and the disease is cured. The case not only expounds the intrinsic link between the cause and development of the disease, but also shows that “heart disease is in need of heart medicine” is one of the main methods of clinical application of this therapy.
The edificatory speech therapy is of great significance in the treatment of physical and emotional diseases due to many comprehensive factors. Miao Zhongchun,a famous doctor in Ming Dynasty, treats Gu Zhonggong whose numb and cold left foot develops to the numbness of the whole body and unconsciousness that is so worrisome. When treating, Miao first analyses that the disease is caused by noninteraction of heart and kidney and dissipation of heart blood due to mind loss, heart damage and sexual taxation. Then he says “noninteraction of heart and kidney will cause separation of Yin and Yang which will be serious” to alert him. Then he urges to “clear mind and dispel lust” and warns the patient to persist in “securing of true essence, containment of Yin and Yang, and physical and emotional comfort”. Finally, the patient is prescribed with medicine and guided the way of health maintenance. In Miao’s case, he treats mainly with explaining, counselling and other edificatory speech methods, combined with drug therapy as well as physical and mental adjustment methods. It manifests a principle of “treating the disease must first treat spirit”.
Attentions
During the diagnosis and treatment, the therapy should comprehensively examine and analyze the patient’s temperament type, affective disorder and pathogenesis. The cause of the disease, age, gender, cultural literacy, economic status, living environment, social status, etc. should be considered to formulate a corresponding edificatory speech therapy. These are the key to obtain a good psychotherapy effect in clinical application.
As the main medium of interpersonal communication, language can either play positive therapeutic effects to relieve the patient’s fear, tension, sorrow, doubts and other negative emotions and emotional disorders and to strengthen his conviction to defeat disease during the treatment process, or the opposite effect of mental burden aggravation or disease worsening due to inappropriate speeches of the doctor or relatives. Therefore, in the application of this therapy, the speaking skills and methods should be paid attention to conduct guidance from person to person. Doctors should do their best to “unbind and open the glue” such as enlightening with reason, emotionally moving, or alerting the wrong, or stretching the mind when using this therapy. “For those who prefer luck, endanger; for those with numerous worries, comfort; for those not convinced, counsel is difficult; for those skeptical, deep words are envious.”(Required Readings from Medical Ancestors) Doctors should pay attention to these similar experiences.
For some patients who have hidden feelings, the doctor should pay attention to the way of asking and the surrounding environment during the conversation to “close the door and shut the windows, tie yourself to the patient, repeatedly inquire about his feelings, adapt your treatment to his sentiments”(lain Questions: Discourse on Moving the Essence and Changing the Qi).The doctor should also explain to the patient that the doctor’s responsibility for the confidentiality of the patient’s condition in order to obtain the patient’s trust and cooperation.
Comments
The use of Edificatory Speech therapy in TCM has a long history. As early as Qin and Han Dynasties, a relatively systematic theory has been formed and applied to clinical treatment. It is not only more detailed and reasonable in terms of observation and classification than temperament classification theory of Hippocrates, the father of Western medicine, of the same time, but also more suitable for clinical treatment. Many methods open a new prospect in modern psychology. Modern medicine noticed the impact of social- psychological factors on health and disease only in the mid-20th century, especially after the 1970s, and gradually carried out psychological counseling and psychotherapy. Therefore, the comprehensive organization and in-depth exploration of theory and treatment methods of TCM psychology will not only help the development and improvement of TCM itself, but also play a beneficial role in promoting the development of modern medicine.