The use of acupuncture in psychotherapy.
Subject: Psychotherapy (Health aspects)
Acupuncture (Methods)
Acupuncture (Health aspects)
Pain (Care and treatment)
Pain (Methods)
Author: Chen, Zhaoming
Pub Date: 09/22/2009
Publication: Name: Annals of the American Psychotherapy Association Publisher: American Psychotherapy Association Audience: Academic; Professional Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2009 American Psychotherapy Association ISSN: 1535-4075
Issue: Date: Fall, 2009 Source Volume: 12 Source Issue: 3
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 208639915
Full Text: Acupuncture followed faith healing and herbology and is the third youngest healthcare art. Through stimulating special points throughout the whole body, diseases and discomfort can be identified and relieved. It is an efficient, inexpensive treatment with little or no side effects. It is believed that acupuncture was initiated in China approximately 3,000 to 5,000 years ago. At that time, the ancient Chinese discovered that stimulation on the body with sharp instruments might reduce acute pain and discomfort. In addition, they found that pre-existing discomfort or chronic pain was also relieved. At first, they thought it was coincidence or luck. However, they figured out that stimulation to different parts of the body could result in a similar outcome, and stimulation to the same point could cause improvement of different discomforts. As more of these points were discovered, a special line was drawn to link them with similar functions. Gradually, these channels were proved to have connections to special. organs; regulating the function of each. This is basis of meridian, where the energy flows much" like blood circulates throughout the body inside blood vessels. There are branches connecting these major meridians. Although invisible to regular people, ancient Qigong practitioners can sense the movement of Qi, the vital energy, or see the meridian. Later on, Yin and Yang theory was introduced to explain the function of points and meridians, instructing diagnosis and the treatment of acupuncture.

After initiation and maturing, acupuncture spread eastward to Japan and Korea, and westward to Vietnam. The French learned acupuncture and brought it back to Europe. Although acupuncture is very popular in almost all European countries, France remains the center of acupuncture in Europe.

It was during the early 19th century that American people got in touch with acupuncture. Dr. Franklin Bache, the great-grandson of Benjamin Franklin, used the needles to treat 17 prisoners with chronic pain. Seven were completely cured, seven more were considerably relieved, and only three people had no response. Many people believe New York Times reporter James Preston introduced acupuncture in America in 197t. In July 1971, Mr. Preston suffered appendicitis while visiting China with his wife, as part of the advance team before President Nixon's historic 1971 visit. After his infected appendix was removed through conventional surgery at a hospital in Beijing, he suffered severe abdominal pain due to gas retention and gut immobility. He was asked if acupuncture could be used; after Preston agreed, Dr. Li Changyuan immediately relieved his post-operative pain with acupuncture. Once he returned to the United States, he wrote an article about his unique experience with acupuncture. The article triggered a number of Americans to rush to China to learn this magic technique, and more schools opened to train acupuncture providers.

The 1998 National Acupuncture Conference concluded that acupuncture, as a therapeutic intervention, can treat a number of medical conditions such as post-operative and chemotherapy-induced nausea and vomiting, as well as dental pain, addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, lower back pain, carpal tunnel syndrome, and asthma. Further research was suggested to investigate the mechanism.

In traditional Chinese medicine, health is achieved by keeping the body in a "balanced state," and disease is a result of imbalance between the yin and yang. This imbalance leads to blockage of Qi (vital energy) flow along pathways known as meridians. Much like the Gulf Stream flows in the Atlantic Ocean, Qi travels in an extracellular manner, connecting blood vessels and cells. These invisible channels and collaterals interact with each other like a highway system or a natural web. Stimulation with needles at certain points on or near these meridians can remove obstruction to regain balance, affecting the function of remote cells.

Qi is derived from inheritance, food, and breath. It is a vital life force and has the function of nourishment and warmth. It is critical for the creation of blood, support of organ function, and movement of the body. In photosynthesis, the sun shines on plants, allowing the leaves to absorb the sunlight and transform the solar energy into starch. Humans eat starch and digest it into small glucose molecules that can be absorbed in the body. In the presence of oxygen, mitochondrial inside cells will convert the glucose into adenosine triphosphate (ATP) through oxidative phosphorylation and electronic transfer chain. ATP circulates throughout the body to supply the energy for maintaining normal cell function. Qi is similar to ATP because both come from food and inhaled oxygen.

Research shows that acupuncture increases the release of painkiller opioids such as endorphins, enkephalins, and dynorphins. It was also proved to reduce c-Fos gene expression and induce vasodilation. Functional MRI provides a unique way to link the remote acupuncture points to the central nervous system. A recent study showed a high signal found in the cortex after acupuncture needles stimulated special points. The signal was absent, both before the acupuncture treatment and when non-acupuncture points were needled. This is indicative of the distant effects of acupuncture.

It has been suggested that acupuncture works through regulation of limbic system functioning, as acupuncture was found to have a significant effect on pain control and drug addiction. The limbic system is also associated with emotion, behavior, and memory. Therefore, acupuncture can be very useful in managing psychological disorders.

Patients with anxiety usually experience chest pain, palpitation, diaphoresis, nausea, tachycardia, tachypnea, trembling, and dizziness. Acupuncture can be effective by stimulating Liv-3 (Taichong), GV-20 (Baihui), Ht-3 (Shaohai), and car acupuncture points for 20 minutes.

In the case of conversion disorder, patients may complain of visual, sensory, and motor dysfunction including--but not limited to--blindness, diplopia, paralysis, dysarthria, dystonia, pseudo-seizure, dysphagia, loss of consciousness, tics, or hallucination. These can be differentiated from stroke, multiple sclerosis, or epilepsy through a comprehensive history and neurological exam, as well as a variety of other tests. It is not uncommon to find stress-related precipitating factors, such as loss of employment, divorce, disease of significant ones, or history of physical, mental, and sexual abuse. Stimulating at GV-20 (Baihui), GV-26 (Renzhong), PC-6 (Neiguan), H-7 (Shenmen), and SI-3 (Houxi), while leaving the needle in place until the disappearance of" symptoms, is very helpful. PC-6 (Neiguan) is also good for emotional instability, such as crying. Use LI-11 (Quchi)and Lu-I1 (Shaoshang)for convulsions, Liv-1 (Dadun) and Kid-I (Yongquan) for stiffness, needle kid-6 (Zhaohai) and CV22 (Tiantu) for constricted throat, and needle BL-1 (Jingming) and TW-23 (Sizhukong) for obstructed vision. Use needle TW-21 (Ermen) and TW-17 (Yifeng) for hearing impairment, and needle CV-22 (Tiantu) for aphasia.

In the case of somatization disorder, patients usually have multiple complaints with no identifiable physical origin. Some of these complaints are nausea, indigestion, sexual and/ or menstrual dysfunction, and pain involving the head, neck, back, chest, abdominals, pelvis, and limbs. Pseudo neurological symptoms may also exist, such as blindness or difficulty walking, speaking, and swallowing. Although abnormal physical and laboratory exams cannot be identified, they interfere significantly with the lives of patients. In this case, needles at GV-20 (BaiHui), HT-7 (Shenman), Sp-6 (Sanyinqiao), St-36 (Zusanli), Kid-3 (Taixi), BL-15 (Xinshu), and BL-23 (Shenshu) would be helpful.

Patients suffering from depression may complain of poor qualin, of sleep, loss of interest, impaired concentration, changed appetite, and lack of energy. In this case, it is beneficial to needle the web areas between toes of the bilateral feet.

Acupuncture instruments have been evolving for thousands of years. These instruments began as sharp stones and developed into the current metal needle that comes in different shapes and sizes. Additionally, cupping, Moxibustion, and electro-stimulation were invented to strengthen the results of acupuncture. If you do not feel comfortable with needles, acupressure is a very good alternative.

With acupressure, it is possible to use your fingers to stimulate the points instead of a needle. Although superficial, it covers a broad area, and more local points will be treated at the same time. All acupuncture points previously mentioned can be used for acupressure treatment. Acupressure is side-effect free and is especially useful for non-professional people to get emergency relief from discomfort. It can "also be used for daily health preservation. For anxiety control, people may massage the place distal to the ankle, proximal to the web area between the first and second toes of bilateral feet, the medial part of the elbow and wrist, or a midline on bilateral anterior forearm between the elbow and wrist.

Another important point is that acupressure is free; therefore, acupressure should be recommended for everyone regardless of income. This do-it-yourself kind of therapy is better than the local pharmacy plan. if someone feels depressed, they can massage four web areas between the toes of both feet. In addition, massaging the web area between the thumb and index of bilateral hands will relieve mild pain. Acupressure is very convenient, as we are carrying 2,000+ medications with us at all times. Spending more time on these "body medications" will significantly reduce the amount of time spent visiting clinical offices and hospitals.

Zhaoming Chen, MD, PhD, MS, CFP, FAAIM obtained his medical degree from Shanghai JiaoTong University College of Medicine, with Hematology and Medicine residency at Rui-Jin hospital, and Neurology residency at Georgetown University. He earned a PhD in Neuroscience from Drexel University, and completed his research fellowship at the University of Pennsylvania. and his Clinical Neurophysiology fellowship from Georgetown University. He was trained in acupuncture from Shanghai University of Traditional Chinese Medicine and Harvard Medical School. He has decades of experience in Tai Chi and holds a certificate from Shanghai Institute of Qigong. He s now a board certified neurologist and clinical neurophysiologist. He has been selected for "America's Top Physicians" for 2009. Dr. Chen was also recently named the Chair and Chief spokesperson for the American Association of Integrative Medicine.
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