Emotion-suppression therapy, a kind of psychological therapeutic method, is established under the guidance of theory of the five phases and restricting emotions. The therapy treats certain physical and mental ailments triggered by extreme emotions through restraining to remove the abnormal emotions.
The theory and therapy concerning emotion-suppression first appear in Internal Classic. Being elaborated in Plain Questions: Comprehensive Discourse on Phenomena Corresponding to Yin and Yang, the emotions belong to five viscera and suppressing emotions (including “anger prevailing over thought” “thought prevailing over fear” “fear prevailing over joy” “joy prevailing over anxiety” “sorrow prevailing anger”), which are the rule of the five emotions that first appear in medical literature. Hereafter, being constantly supplemented and improved in terms of theory and clinical treatment, especially by Zhang Zihe, Zhu Danxi and other famous doctors in the Jin and Yuan dynasties, the therapy has become one of the main psychotherapies in TCM.
Basic Contents
Joy, anger, anxiety, thought, sorrow, fear and fright are called seven emotions in TCM. They’re the modal responses of people’s subjective feelings to external things. Ancient physicians attach great importance to the influence of emotional activities on the human body. In the course of long-term clinical observation, physicians realize that these modality reactions are intrinsically related to the visceral functions, and classify them with five viscera. In Internal Classic, joy is related to heart and belongs to fire; anger is related to liver and belongs to wood; anxiety (sorrow) is related to lung and belongs to metal; thought is related to spleen and belongs to the earth; fear is related to kidney and belongs to water. It is considered that human emotional activity is based on the essence of five viscera and is also one of the external manifestations of viscera. That is the connotation that” if five viscera are stable, blood vessel will run smoothly and the spirit will be eternal” in Spiritual Pivot: Fasting for Healthy People. If someone is suddenly subjected to intense mental stimulation or persistent mental trauma, his emotional activities will go beyond the scope of the body’s endurance and self-regulation, which will lead to the imbalance of Yin and Yang of the body, the inverse disorder of Qi and blood, and thereby impair the normal physiological functions of the viscera. The intense extreme emotion has its correlation and specificity on the impact of human visceral functions. Based on the damage of extreme emotion to human visceral activities, theories like “anger damaging liver” “joy damaging heart” “anxiety damaging spleen” “fear damaging kidney” “thought damaging spleen”, etc., are summarized by long-term clinical observation. At the same time, viscera give rise to pathological changes of deficiency and repletion which will generate abnormal emotional reactions of patients, such as “deficiency of heart Qi causing sorrow, while repletion causing consistent laughing”, “deficiency of liver Qi causing fear, while repletion causing anger”(Spiritual Pivot: Spirit-based Acupuncture), which is the sign of abnormal emotional changes of all viscera diseases.
The functions and activities of the viscera are closely related to each other. In order to maintain the physiological and psychological coordination and stability of the human body, the viscera are mutually generative and mutually restricting. This relationship is explained and reasoned by mutual generating and restraining among the five phases. In the theory of the five phases, the order of wood, fire, earth, metal and water are born one after another, which constitutes the promotion and generative relationship, and the lines of metal, wood, earth, water and fire are mutual restraining, which in turn constitutes the relationship of restraint and restriction. With the mutual generating and restraining between one thing and another, nature can be stable and unified; With the internal mutual generating and restraining of things, they can maintain coordination and development of themselves. Under the circumstance that extreme emotion damages the mental and physical homeostasis, physicians stimulate the phase being restricted to control the excess according to the five elements of emotions and their rules, so as to restore or reconstruct patients’ psychosomatic harmony, and achieve the purpose of treating the mental and physical diseases. Zhang Jingyue, a doctor of the Ming dynasty, emphasizes in the elaboration of emotion-suppression rules in Internal Classic that “if one of the five emotions is excessive, use the other to restrict it”, and he reveals the application basis and purpose of the therapy.
There are two treatments, the five emotions restricting therapy and looping therapy, which are described below.
Five Emotions Restricting Therapy
1. Anger Prevailing over Thought
Thought is controlled by spleen and belongs to the earth. Thinking is a reflection of the process and ability of human beings to perceive things, which is not emotional in itself. People may feel anxious in that they are unable to understand or predict the outcome of an event. Therefore, in Internal Classic, “palpitation, thought and fright” and “anxiety and though” are described as one of the seven emotions. In daily life, excessive thinking caused by the things lingering in the heart or diligence often can cause symptoms of thought damaging spleen and dysfunction of spleen in transportation such as lack of appetite, abdominal fullness, and even anorexia, limb laziness. People who have been engaged in mental work for a long time suffer from insomnia, forgetfulness, palpitation and other signs
of mental nourishment failure due to excessive stress, which is believed in A-B Classic of Acupuncture and Moxibustion to be the cause of “thought comes from spleen and forms in heart”. Anger is liver’s emotion, and liver governs free coursing. Anger helps liver Qi rise, releasing bad emotions and rebuilding psychological balance. “Anger prevailing over thought” is the relationship of wood restraining earth from the perspective of the five phases. In terms of the physiological functions of the viscera, free coursing of liver Qi helps to activate spleen and release Qi. Therefore, in the clinical practice, methods such as deliberately disobeying the patient’s mind or taking away the patient’s beloved objects, etc. are often adopted to trigger his anger, so that the Qi can be released to the fullest extent, which can correct the pathological changes of “thought causing Qi stagnation”.
2. Thought Prevailing over Fear
Fear is controlled by kidney and belongs to the water. It is a psychological reaction of the body, often associated with sudden shock, insecurity or fear in the face of an emergency or abnormal situation. Most of this fear will pass with time, and people need not worry about it. If people are exposed to a tense and fearful atmosphere for a long time, the body will always be in a state of stress, resulting in impaired physiological function. In severe cases, patients in sudden and continuous shock may have symptoms of “fear causing Qi sinking” such as urinary and fecal incontinence, seminal emission, efflux, diarrhea and so on. Patients often or persistently in fear will have restlessness, anxiety accompanied by the clinical symptoms of kidney damage and loss of essence, including bones and limbs weakness, thin and weak, even infertility so on. Treatment is often difficult to achieve by relying solely on medication without trying to free the patient from fear. Therefore, clinical treatment needs to be combined with psychological therapy like “thought prevailing over fear’. If the doctor can induce the patient to think according to the cause of fear and timidity, combining with the method of broadening their knowledge, strengthening their determination, thereby they can help patients gradually get rid of panic and fear.
3. Fear Prevailing over Joy
Joy is controlled by heart and belongs to the fire. “Joy causing Qi to slacken” mainly refers to the excessive joy will make people appear distracted, out of mind and spirit failing to keep to its abode. It is often characterized by an inability to concentrate, a trance, or even laughter in a state of madness. This kind of disease belongs to repletion pattern in that the treatment in clinic is mainly to clear heart and reduce fire. Fear causes timidity of Qi. If a doctor suddenly uses things that patients are usually afraid of to treat just like putting out fire with water, that’s why there is a method called “fear prevailing over joy” .The Scholars describes how Fan Jin goes into a delirium after he passes the provincial civil service examination under the old Chinese examination system. Because he is afraid of his father-in-law in peacetime, he recovers his mind after his father-in-law beats and scolds him. Although this is the plot of the novel, it is very suitable for the medical theory of fear prevailing over joy.
4. Joy Prevailing over Sorrow or Anxiety
Anxiety belongs to lungs as much as sorrow. “Sorrow causing Qi consumption” refers to excessive sorrow would cause Qi consumption and dereliction of duty. In most cases, people feel sad because of the death of a friend or relative, setbacks, long illness, which often appear to be sad, depressed, crying for o reason, sighing, dejected and pessimistic, leading to a condition of gauntness. A doctor can use the things that patients like to listen to and are willing to see in order to make people in sad or anxiety smile again. That is the method of joy prevailing over sorrow or anxiety.
5. Sorrow Prevailing over Anger
Anger is controlled by liver. Rage causes transverse attack by liver Qi which means Qi and blood run upward together. From this, patient can have several symptoms such as irritability, flushed face, headache, dizziness, tinnitus, even hematemesis and fainting. Sorrow causing Qi consumption means anger can be suppressed and emotions can be restored. Therefore, there is a saying “sorrow prevailing over anger”. When the patients get angry, the doctor should try his best to comfort and persuade to move and cry, and eventually the anger can be released.
Investigations of Medical Prescriptions says that “Only drugs can not cure excessive emotional sensitivity, but Emotional Therapy is needed. After that, all dynasties have developed the theory of emotion in Internal Classic, which is an invisible medicine. If a good doctor can understand by analogy, he will master this technique.” In Confucian’s Duties to Parents, Zhang Zihe believes that “Sorrow can suppress anger. Doctors need to touch patients with sad words. Joy can suppress sorrow. Doctors should use humorous words to make patients laugh. Fear can suppress joy. Doctors should scare patients with horrible words. Anger suppresses
thought. Doctors should use words to provoke patients. Thought can suppress fear. Doctors should use words to worry the patient. All the five therapies must be applied craftily and weirdly so as to confuse the public. If the doctor has not learned the theory, he cannot use the five therapies. “Zhang’s explanation of the five emotions restricting therapy, especially the many examples in the book, reflects his ingenious conception and gives many inspirations to later doctors.
Looping Therapy
Looping therapy is put up with by Zhu Danxi,one of the four great scholars of Jin and Yuan dynasties. Besides, he supplements “the treatment by the generating ones”. Take the treatments of psychosis, mania and epilepsy diseases for example, Zhu Danxi emphasizes that these kinds of treatments couldn’t be pure use of medicinal stones, but must be accompanied by “the method of emotional intervention”. Therefore, he develops looping therapy with emotional intervention. He points out that “the manic and psychosis due to anger attacking liver can be controlled by anxiety and cured by fear; the psychosis and epilepsy caused by joy attacking heart can be controlled by fear and cured by anger; the epilepsy and psychosis due to anxiety attacking lung can be controlled by joy and cured by thought; the epilepsy and psychosis caused by thought attacking spleen can be controlled by anger and cured by joy; the psychosis resulted from fear attacking kidney can be controlled by thought and cured by anxiety; the psychosis due to freight attacking gallbladder can be controlled by anxiety and cured by fear; the psychosis caused by sorrow attacking pericardium can be controlled by fear and cured by anger.”(Medical Records from Danxi’s Experiential Therapy)Zhu’s looping therapy not only expands the restriction of five emotions from Internal Classic into restriction and domination of seven emotions, but also supplements the accompanying treatments of emotional stress remission by “the generating one” according to mother-son relationship, which make such treatments more flexible in clinical practice.
Sometimes, it may be a little far-fetching to regard the restriction of five phases as the treatment mechanism of emotions domination. However, emotional activities can be attributed to Yin or Yang in Yin-Yang theory, while from the modern psychological perspective, the emotional relationships can be differentiated by such polar characteristics (opposition) as anger and fear, joy and sorrow, fright and thought. Anger is attributed to Yang with its polar characteristic of Qi rising and flowing outward; fear is attributed to Yin with its polar characteristic of Qi flowing downward and inward; joy is attributed to Yang with its polar characteristic of spirit dispersion; sorrow is attributed to Yin with its polar characteristic of Qi blocking; fright is attributed to Yin with its polar characteristic of Qi disturbing, which leads to palpitation, mental distraction and hesitation in making decisions; thought is attributed to Yin with its polar characteristic of Qi stagnation. The Yin-Yang opposite relationship among emotions constitutes the contradictory relations physically and pathologically, leading to relative predominance and disorder of Yin or Yang in viscera, Qi and blood aspects. The basic principle of emotional restriction treatments is that the relative predominance of Yin and Yang due to emotional stress is controlled and restricted by its corresponding opposite one, which functions to balance the relationships between Yin and Yang, Qi and blood. Thus, a conclusion can be reached that anger dominates fear and is restricted conversely; joy dominates anxiety and is restricted adversely; fright dominates thought and is restricted on the contrary… Such polar opposite relationship by fully using of emotional activities, as a relative restriction and domination treatment, can make itself have greater development without the necessity of limitation of five phases.
Clinical Application
The emotional restriction treatment plays a better role than medicinal and other treatments in emotional stress remission, emotional diseases and various mental diseases caused by extreme emotions physically and pathologically. The emotional factors should not be ignored to the development, treatment, prognosis of disease, thus, this treatment can have corresponding effects in mental and physical diseases.
Yang Shangshan, the famous physician in Sui Dynasty, has some incisive opinions on the applications of this treatment. He notes in Grand Plain of Huangdi’s Internal Classic that “The diseases caused by wind, cold, summer heat, dampness, diets and intercourse can be treated by acupuncture and decoction; the treatments of emotional diseases must be combination of the emotion regulation, acupuncture and medicine”. Hence, the mental diseases should be treated psychologically at first by restriction of the extreme emotions, the physician should regulate patient’s emotions before using other accompanying treatments in the case of diseases involving other pathogenic factors.
It is the key point to manipulate the mental characteristics of the patient in this treatment. For instance, a rich woman suffers from insomnia for two years, which is immune to hundreds of treatments. Zhang Zihe diagnoses the disease as thought damaging spleen pattern according to her soft pulse. He irritates the woman to sweat, lie down and rest for several days by “applying the money to buy alcohol”, which is supposed to cure disease. At last, he cures that woman in this way (Confucians’ Duties to Parents). A scholar, living alone in a dark room, who is susceptible to fall ill in the case of occasional going out. Li Jianang, a physician in Qing Dynasty, cures this scholar with a set of herbs after reading his essay loudly and in a confused way deliberately to irritate him. (Medical Figures in Sichuan) The former case of anger restricting thought is based on the fact that the woman with narrow-minded and tightfisted mental status irritated by Zhang’s deliberate treating rejection; the latter one is based on the fact that the scholar with pretentious mental status irritated by Li’s deliberate essay misunderstanding. Take another case for example, a woman develops a disease after her husband go out for business for two years, which is characterized by anorexia, bed- ridden taciturnity and dementia. Zhu Danxi asks her father to irritate her by scolding and slapping her on the face, and then Zhu Danxi gives her spleen-activating medicine. At last, the woman begins to have some porridge after a set of formula, and then her disease is cured by joy from the fake coming-home message of her husband (Comments on Ancient and Modern Cases Records). The above three cases are all thought damaging spleen pattern. Physicians treat patient ingeniously according to the state of the illness and mental characteristic of the patient by using methods of anger restricting thought, accompanying treatment of formula and looping therapy. Therefore, it is necessary to apply this method according to pattern identification and treatment, and treatment in accordance with person, time and place.
Attentions
The treatment is not only applicable to remission of emotional stress, treatment of neurasthenia and hysteria, but also has some accompanying treating effects in psychopathy or morbid emotions. Those with weak constitutions or serious organic diseases should use with care.
The physician should observe and understand deeply about the patient’s living environment and mental characteristics, analyze carefully the cause of disease and abnormal mental reactions with combination of pathogenesis of viscera, Qi and blood, deficiency and repletion to get an appropriate treatment before applying the therapy.
The physician should be familiar with Yin-Yang and five phases theory of TCM, relations of mutual transformation between generation and restriction. It is also vital to assess the situation and have an inquiring mind for physician to cure disease with the treatment of emotional suppression.
The stimulus intensity should be noted during the treatment of emotional diseases, that is the therapeutic emotional stimulus usually exceeding the morbid ones, otherwise it is impossible to achieve the treatment effects of emotional suppression.
Comments
The principle and method of this therapy have distinctive TCM characteristics, which is lacking in modern psychology. If used appropriately, it can have miraculous treatment effects. It is helpful for the improvement of the treatment level of mental or physical diseases to research deeply and review systematically the rich clinical experiences of ancient famous physicians.