Emotional therapy is an important part of Traditional Chinese Medicine (TCM) and TCM’s holistic view. It emphasizes that people’s emotional activities (including mental, consciousness, and thinking activities) are based on the function of bowels and viscera. Emotional activities are of significant individual differences and influenced by the natural and social environment.
Emotional activities mentioned in ancient books include joy, anger, sadness, happiness, love, dislike, desire, worry, thought, sorrow, fear, surprise, doubt, hate, etc. There was a variety of emotional classification methods in ancient times, such as:
The Commentary of Zuo puts forward the “Six Minds”, which says, “People’s like, dislike, joy, anger, sorrow and happiness are born of six Qi. Therefore, etiquette is set to restrain six minds” in the Year 25 of Duke Zhao in the Commentary of Zuo. Xuncius called “Six Minds” as “Six Affects”. Year 25 of Duke Zhao in the Commentary of Zuo records: ” Like, dislike, joy, anger, sorrow and happiness of nature are called affects. “Rite and Luck of The Book of Rites has records of” seven affects”: “What are the human affects? They are joy, anger, sorrow, fear, love, dislike and desire.”
There are also many discussions about emotions in Internal Classic. For example, Plain Questions: Comprehensive Discourse on Phenomena Corresponding to Yin and Yang records: “Man has the five viscera which transform the five Qi, thereby generating joy, angry, sadness, anxiety, and fear.” Plain Questions: Discourse on Pain says: “Hundreds of diseases arise out of Qi. The Qi rises while one is angry. And it relaxes while he is joyous. When one is sad, then the Qi dissipates. When one is in fear, then the Qi moves down. When one is frightened, then the Qi is in disorder. “In the former discourse, joy, anger, sorrow, anxiety, and fear are called “five minds”, while in the latter discourse anger, joy, sorrow, fear, anxiety, and fright are the six kinds.
Chen Wuze of Song Dynasty proposes in Treatise on Disease, Patterns, and Prescriptions Related to Unification of the Three Etiologies: “Seven affects are joy, anger, anxiety, thought, sorrow, fear and fright. “This statement is more reasonable than the “seven affects” in The Book of Rites.
Among the above classifications, the most influential to TCM are the “five minds” of Huangdi’s Internal Classic and the “seven affects” of Treatise on Disease, Patterns, and Prescriptions Related to Unification of the Three Etiologies. The two are often called” affect-mind”.
Modern psychology believes that there are four basic types of emotions, namely happiness, sadness, anger and fear, and other emotions derive from the four. For the “five minds” of Internal Classic, joy, anger, anxiety and fear, which belong to the emotional process, just match the four types of emotions, if thought-a process of cognition in terms of modern psychology, removed.
Since the Qin and Han Dynasties, ancient scholars have carried out many discussions on the generating principles of emotions, and they believe that emotions are sense of things and are stimulated by the external stimuli. For example, Huai Nan Tzu: Original Tao says: “Wisdom of things generates likes and dislikes.” Zhu Xi also says: “Joy, anger, grief and happiness originate from sense of things, which likes the shape in the mirror. Is there a shadow if there’s nothing in front of the mirror?” Li Zhongzi, a doctor in Ming Dynasty, attributes the factors that stimulate emotional response to two categories, namely “encounter” and “need”. The former involves external stimuli and the latter relates to one’s own desires. Affect and desire no doubt belong to “human nature”, however, excessive activities will cause damage to the body and mind. Therefore, passionate activities should be moderate, neither too many nor too few. Just as emphasized in Fine Prescriptions in Emergency, “anxiety, thought, joy and anger are ones without which man cannot live while excessive of which will damage the five viscera.”
The method of regulation and treatment based on emotion theory is called Emotional Therapy. Emotional Therapy generally does not involve drugs, acupuncture, surgery and other “tangible” treatments. It affects the patient’s psychological activities, arouses the positive factors of patients’ prevention and treatment of diseases, and promotes or adjusts the functional activities of the body to achieve a therapeutic or healing effect by means of speech, behavior and specially arranged scenes. It is similar to psychotherapy in modern medicine in terms of methods, means and clinical effects.
There is no such thing as psychology or psychotherapy in TCM. However, there are many similar titles in the traditional literature. The most influential ones are “treating spirit” from Plain Questions: Discourse on Treasuring Life and Preserving Physical Appearance, “treating reflection “from Supplement to Classified Case Records of Famous Physicians,” curing heart “from Secret Record in a Green-blue Pouch, “restraining of human affairs” from Danxi’s Experiential Therapy and so on. TCM contains a wealth of theory and practical experience of Emotional Therapy.” Heart disease still needs heart medicine” is a famous saying that everyone knows. Emotional Therapy is actually one of the earliest forms of treatment. It used to be the dominant form of treatment in ancient times.
American scholar Murphy once said: “The first hometown of the world psychology is in China.” Prescriptions for Fifty-two Diseases, compiled from the Mawangdui Han Tombs, an ancient medical book researched to be earlier than Internal Classic, boasts 35 cases of “invoking origin to treat diseases”.
Internal Classic, published more than 2 000 years ago, is not only the origin of TCM theory, but also the earliest work of emotional illness and its treatment. It recognizes that human psychological factors are closely related to the occurrence, development and prognosis of diseases. In terms of treatment, it places “treating spirit” at the head of various methods. Treatments such as “needles, (pointed) stones, and toxic drugs” must stimulate the patient’s spirit to have the therapeutic effect. Spiritual Pivot: Instructions of the Teacher says: “It is human who 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, guides them to do what they like for restoring their health and tries 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 penetrating comment is still widely used as a classic emotional (psycho) treatment theory. Plain Questions: Comprehensive Discourse on the Progression of the Five Periods and Plain Questions: Comprehensive Discourse on Phenomena Corresponding to Yin and Yang have recognized the dialectical relationship physiologically and pathologically between mental factors and viscera, as well as emotions and emotions, and created the therapy of mutual domination of emotions, that is, “Anger harms liver; sadness dominates anger. Joy harms heart; fear dominates joy. Thought harms spleen; anger dominates thought. Anxiety harms lung; joy dominates anxiety. Fear harms kidney; thought dominates fear.” cleverly based on the principle of “rescuing tendency with tendency”.
Plain Questions: Discourse on Moving the Essence and Changing the 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.” Spiritual Pivot: Thief-like Wind further elaborates the theory of invoking origin to treat diseases.
Huangdi said,” Some people who are never attacked by evil Qi and have no emotional changes like fear and terror suddenly fall ill. What is the cause? Is it caused by ghost and evil?” Qibo said, “This is also due to latent evil that stays inside the body but has never attacked. When there appear such emotional changes like disliking something or desiring something, it will cause disorders of blood and Qi which will interact with the latent pathogenic factors inside the body. Such interior changes are subtle, invisible and noiseless. That is why it occurs like the haunting of ghosts and devils.” Huangdi said, “Why it can be cured by praying?” Qibo said, “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”.
According to this, Zhang Jiebin, a famous doctor of the Ming Dynasty, makes a further elucidation in Classified Classic: “Knowing its prevalence and origination can be cured by invoking. It is to seek the origin of the disease and release the ghost in heart… Once the root is obtained, there is a therapy. Therefore, invoking won’t be ineffective after examination of his dislike, plan, prevalence and origination.”
In addition, “hiccup also can be stopped by sudden shock” from Plain Questions: Discourse on Strange Diseases, while “fright is treated by calming” from Plain Questions: Comprehensive Discourse on the Essentials of the Most Reliable and other related records reveal that emotional related therapy has been applied in the clinical practice. As for “They exhaled and inhaled essence Qi, they stood for themselves and guarded their spirit. Muscles and flesh were like one.” from Plain Questions: Discourse on the True Qi Endowed by Heaven in High Antiquity, “guiding-pulling and pressing-lifting” from Plain Questions: Discourse on Different Therapeutic Patterns Suitable for Use in Different Cardinal Points, as well as “tranquilizing the mind and eliminating avarice, holding the breath (only inhalation and no exhalation) for seven times” from Plain Questions: Discussion on Acupuncture Methods and so on advocate positive Qigong or guidance methods to tranquil heart, guard spirit and regulate spirt to achieve the purpose of disease prevention and treatment. These statements in Internal Classic are not only the earliest psychiatric treatment in the world to treat Qi and blood disorder through invoking origin, that is, to pray and interpret the cause of the disease, or to be freed from the sufferings of spiritual concern, but also reflect the pivotal therapeutic status of invoking origin at that time. Therefore, from invoking origin appeared in Internal Classic to the specially setting up of departments of medicine, needle, massage and exorcism (invoking origin)in Tang Dynasty, the hard journey of emotional (psychological) treatment of TCM can be seen from germination to maturity.
Although there is no discussion about emotional treatment in Treatise on Cold Damage, Zhang Zhongjing clearly states in Synopsis of the Golden Chamber: On Pulse, Symptom Complex and Transmission of Diseases of the Viscera, Bowels, Channels and Collaterals that it should be paid attention to regulate the mind and body during the treatment of the disease.
There are a large number of masters to treat emotional illnesses during the Jin and Yuan Dynasties. For example, Zhang Zihe emphasizes in Confucians’ Duties to Parents: Diseases Contracted From Nine Qi Be Treated One With Another: “Sorrow can treat anger, wih painful words to move; joy can treat sorrow, with jokes to amuse; fear can treat joy, with threatening words to intimidate; anger can treat thought, with insulting words to enrage; thought can treat fear, with worrying words to deprive.” “Idleness can treat taxation.””Accustomization can treat fright.” “Diseases contracted from nine Qi can be treated one with another.” He extremely exquisitely interprets the theory of affect-mind mutual domination in Internal Classic. His emotional medical records are ingenious in design, in-depth and complete in treatment, and classic in appraisal. These medical records boast a very high-level no matter from the theoretical analysis of TCM or from the perspective of modern psychotherapy, and extend the considerable influence to psychology and its treatment not only mainland China but also the world. Luo Tianyi, Zhu Danxi, Jia Sicheng, etc. of the same period also leave many fruitful emotional medical cases. It should be noted that in the minority medicines of our country, there are applications of similar methods, such as Yelv Dilu’s enraging to discharge toxin in Liao Dynasty.
Miao Zhongchun in the Ming Dynasty says in Dissemination of the Classic of Materia Medica: On Seven Affects: “Affects are mental, uncertain, and untraceable. They appear in the encounter with circumstances and their stagnations are difficult to free. “And there is the possibility of “recurrence in the future”. For the treatment, “It is only suitable to condemn insight with insight and to condemn reason with reason, which means heart disease will be treated with heart medicine. If so, stagnation is freed; binding is transformed; affects separate with circumstances without interference. The place is still, and the heart is calm.How can be burdened with seven affects?” Zhang Jingyue makes new progress based on the interpretation of Emotional Therapy in Internal Classic. Classified Classic: On treatments has made a profound analysis of ghost spirit and invoking origin with the citation of emotional treatment records of his and others. Jing Yue’s Collected Works makes a historic contribution to the treatment of malingering. The Ming Dynasty witnesses the most emotional treatment records in the history of TCM.
Wu Shangxian of Qing Dynasty says in Rhymed Discourse for External Remedies: “Contraction of lust cannot be cured with medicinals. A disease of seven affects should be treated with affects.” There are only a few scattered records about psychotherapy during this period, and most of them are paired with or subordinated to acupuncture or medicine. However, it has a positive significance in terms of the collection of psychotherapy medical records. Chen Menglei has more than 30 cases of psychotherapy in Complete Medical Works of the Library Collection, Ancient and Modern.Wei Zhixiu’s Supplement to Classified Case Records of Famous Physicians also has more than 20 cases that are divided into categories by malingering, love-sickness and so on. Yu Zhen’s Comments on Ancient and Modern Cases Records is good at the selection of cases and incisive in the comments although its case number is fewer than the previous two books.
From the rich clinical practice, doctors of the past generations sum up that “a heart disease still needs heart medicine”, and propose that “to treat heart disease without knowing the medicine and its properties, dosage and producing area but with a good effect”. It can be seen that “heart medicine” is not a real drug but an emotional adjustment. Zhao Yanhui of Qing Dynasty clearly states in Medical Discussion Notes of Cun Cun-zhai that “ruthless herbs and trees cannot treat affect diseases and the refractory people or diseases should be treated with a silver tongue”. For those doctors who do not pay attention to emotional treatment, Treasured Mirror of Oriental Medicine has given sharp criticism:”Ancient sacred doctor can treat people’s heart to prevent from becoming sick; today’s doctors only treat people’s diseases without knowing the heart, which likes attending to trifles and neglecting essentials. Isnโt it stupid to desire a healing by attacking the course without knowing the source?”
As an important part of TCM, Emotional Therapy has contributed a lot to the maintenance of Chinese people’s health. Psychological disorders, psychosomatic diseases, neuropsychiatric diseases and social maladjustment have become the main factors affecting the health of modern people. Their harmfulness is rapidly rising, attracting the attention of the whole society, and requiring a lot of energy and material resources to study and tackle. For these psychotic and psychosomatic diseases, the simple use of medicine is often insufficient or even ineffective, while the psychological treatment plays a positive role.
At present, psychotherapy in China basically introduces and imitates Western theories and models, and is deeply influenced by Western culture and social customs. The credibility and feasibility of these results have certain geographical restrictions in spite of the rigorous design, advanced means and empirical evidence. There are many differences between China and the West in historical evolution, cultural traditions, social structure, economic conditions, values, customs and other social and cultural aspects. The personality characteristics and psychological state of Chinese people are also very different from those of Westerners, resulting in unique psychological problems and disorders. Even for the same type of psychological problems and disorders, Chinese and Western people often differ in their specific causes and symptoms. Chinaโs psychological treatment cannot simply and mechanically apply Western theories and models, and must have an in-depth understanding of Chinese traditional culture. Emotional Therapy is basically consistent with the definition, means and effects of modern psychotherapy. Chinese psychotherapy with traditional Chinese cultural characteristics is more suitable for personality characteristics of Chinese.