Chinese Medicine and Excess

You have all seen those familiar black and white symbols that represent Yin and Yang. You can find them everywhere: on T-shirts, in tattoos, on holistic websites all over the internet. When asked what these symbols mean, most people will answer that this symbol represents balance. This is true, but there is so much more to it than that. In the world of Yin and Yang, one cannot exist without the other. There can be no light without darkness, no up if there is no down. The balance of Yin and Yang is integral to every aspect of our health, and much of what we acupuncturists do centers around keeping the two in a form of relative balance. If either the Yin or the Yang fall out of balance, one side will be deficient of energy, and the other side will be in excess.

So what does this mean? Let’s start with an example of a person who might be displaying symptoms of an “excess” personality type. Imagine that you are sitting in your office, waiting for this person to come in. As you wait, your door suddenly slams open and your patient bursts into your office. He is sweating, red-faced, irritated, and loudly asks if this is the right place. Before you can answer, he begins to vent about the traffic. He sits, but seems to have a hard time being still; he fidgets and gestures wildly as he speaks. As you speak with him, you can’t help but feel drained as his frenetic energy fills the room; it’s difficult to get a word in edgewise. Patients who exhibit signs of excess are often hot, loud, and move quickly. They may seem impatient and have a difficult time relaxing. These patients can be prone to issues like high blood pressure, anger, anxiety, headaches, and TMJ.

When we acupuncturists diagnose, an imperative part of our job is to determine if the symptoms the patient is experiencing are due to excess or deficiency, and treat accordingly. We don’t simply treat dysfunction; we first find the root of the issue. Excess conditions are generally more acute, hot, and painful. If a pain condition feels worse with pressure, it is usually excess. If the pain is alleviated with pressure, it is more likely to be caused by deficiency. Blood stagnation, a common cause of pain, is an excess condition. In a healthy, pain-free individual, the Blood flows through the body smoothly and easily. When there is trauma, that smooth flow of Blood is interrupted and it becomes stuck and stagnant. This leads to pain that is intense and worse with pressure.

Any system of the body can be affected by either excess or deficiency. Excess energy in the Liver can lead to intense headaches, neck and shoulder pain, agitation, or insomnia. The mind cannot rest with all of that excess energy rising upward. Excess in the Stomach might manifest in heartburn, indigestion, or uncomfortable sensations of hunger. Heart excess could result in a rapid, pounding heartbeat. Excess energy of the Lung might lead to a strong, productive cough. And excess of the Kidney might show itself with a painful UTI.

Aside from examining symptoms, we also use tools such as the pulse and tongue to differentiate between excess and deficiency. When you visit your acupuncturist, you may notice that he or she will ask you to stick out your tongue. Examining the tongue gives us important information about what is going on with your health. An “excess” tongue might be quite red; this is a sign of excess Heat. In comparison, a tongue displaying signs of deficiency could be pale, thin, or have toothmarks on the side.

Once your acupuncturist looks at your tongue, he or she will then likely take your pulse. This also gives us a lot of insight as to the levels of excess and deficiency. An excess pulse would be rapid, full, pounding, and forceful. It might also feel “choppy”, as if the smooth flow of blood is impeded. Since stagnation is a form of excess, Blood stagnation would create this type of excess pulse. Often people who are in pain will have this pulse.

Diagnosing the difference between excess and deficiency is another way for your acupuncturist to take a look at the whole picture, and to treat the entire essence of “you”, rather than just your symptoms.

Imagine This...

Imagine this scenario, if you will. You are at the mall, and you see a woman looking over a rack of clothing with her teenage daughter. As they dig through the articles of clothing, you start to hone in on their conversation: Girl: "I like this top."

Mom: "That shirt is beautiful, but not on you. You would just look washed out with your pasty white skin."

Girl: "Ok, maybe this one?"

Mom: "This one is nice, too, but no one as fat as you should be wearing something that tight. You'll look horrible in it."

Girl: "I'm going to go meet up with my friends now, and do some studying for my exams."

Mom: "You're just saying that; you know you'll never actually get anything done. You know you're going to procrastinate, because that's what lazy people do. And even if you do get some studying done, it won't be enough to make up for the fact that you just aren't smart or capable enough to do well on your exam."

Cue complete rage and righteous indignation upon hearing this, right? We all respond differently to uncomfortable situations, but at the very least most of us would be disgusted by this type of degradation. Some of us might even interject with a scathing remark, or a warranted scolding.

Now, let's back up a minute. Hearing these thoughts expressed aloud to another human being is enough to make the majority of us experience emotions ranging from irritation to fury. So, why is it that so many feel perfectly content and comfortable speaking to themselves this way?

If we spoke to others the way we speak to ourselves...well, there would probably be a lot more fistfights out in the streets. After treating a particularly self-deprecating patient last week, I decided to keep track of the disparaging comments that flow so effortlessly from the mouths of those around me. It was a loooong list. Even when I wasn't hearing phrases birthed from actual self-hatred, there were still plenty of casual meannesses to go around:

"God, I'm so stupid."

"If I had a brain, I'd know this..."

"As usual, I didn't get anything done..."

"I can't do anything right."

Now, seriously, switch this up for a minute. Imagine that you are speaking with a colleague, and this is what they are saying to you: "God, you are so stupid. If you had a brain, you'd know this. As usual, you got nothing done. You can't do anything right."

What an ass, right? This is the type of person you would avoid at all costs. Yet you probably said a few of these phrases to yourself at some point today, and thought nothing of it.

We become what we imagine. We visualize our truths, and then make them our own. Every time you repeat to yourself that you aren't capable, that you aren't bright, that you can't help but to screw everything up...this is you creating your reality. Repetition breeds habit. Each time you engage in this negative self-talk, you are psyching yourself up to fail, to fall, to disappoint...and not only yourself. Spend enough time convincing those around you of your worthlessness, your ineptitude, and eventually, guess what? They will all believe you.

It's not so very difficult to flip the script. To become more conscious of the words and thoughts that are flowing from your unique and brilliant little brain, and to simply put them on pause. Assess these thoughts, whatever they may be. Are they helpful? Are they energizing? Do they lift you up in any way, or do they simply bring you down? If they have no use, just cut them off at the root. Let them wither and die; they have no place in your life.




The Return of Ranchi Ho

In the world of acupuncture, there are endless styles and techniques. You can go to ten different practitioners and experience ten completely different sessions-and all of them may work for you, as long as the practitioner is on the right track with the diagnosis. Acupuncture isn't just about needles. There are acupuncturists who treat without inserting a single needle. We also use a variety of tools to speed up the process of healing. Some of these include cupping, guasha, and moxa. For those who are unfamiliar with these terms, cupping is a modality in which flame is placed inside glass cups, which are then quickly put onto the skin after the flame is withdrawn. The flame sucks up the oxygen, which creates a tight suction between the skin and the cup. It feels like the opposite of a massage: whereas massage is pressure against the musculature, the cupping sucks at the area, like a reverse massage. It feels wonderful, helps to increase the circulation, and even helps with respiratory issues.

Guasha is a technique that involves sliding a flat, hard, smooth object over lubricated skin. It breaks up tightness and is miraculous in restoring range of motion in the neck. My patients are usually blown away by how beneficial it is, and how quickly it works. Old-school practitioners use Chinese soup spoons, but I prefer my curved jade pieces. Really, though, you can use anything with a flat smooth surface to get the job done. A few months ago, my boyfriend tweaked his neck, and I didn't have any of my tools at my house. I got the job done with a baby food lid and Vaseline...tacky, but effective :)

Moxa is an herb that we burn to promote blood flow, reduce pain, and warm up cold areas of the body. I'm going to post a whole other blog about that this week, since I've gotten a lot of questions about it lately.

With the wide variety of tricks I have in my bag, I sometimes go through phases with techniques. One particular technique that has made a comeback recently is called "Ranchi Ho." It is a combination of cupping and bloodletting, and it is every bit as exciting as it sounds!

I first experienced the magic of Ranchi Ho while still in grad school, and I never forgot the profound effects it had on one particular patient. During my grad school years, I spent several semesters interning in the school clinic. Every week, for years, the same elderly woman would schedule a session...and every week, for years, she complained bitterly about acupuncture not doing anything for her. She was infamous around the clinic for being a curmudgeon, and everyone always wondered why she bothered coming back if she hadn't gotten relief in her hundreds of sessions. This woman was in a wheelchair, and her neck was bent so severely to the side that it approached a 90 degree wonder she was grumpy!

On the day that it was my turn to treat her, I decided that all of those years of being fixed in that position in the chair must have led to a degree of stagnation that needles alone couldn't move; it was time to pull out the Ranchi Ho.

What followed was simultaneously so delightful, and so, so awful. Delightful, because I am a person who savors disgusting things; I'm the first one to volunteer to get out that ingrown hair, or to pop a pimple. Awful, because...we'll, you'll see...

The woman was propped up in her wheelchair; I gloved up and cleaned her neck and back with alcohol. I explained that I wanted to try a new technique on her that might feel a bit prickly, as I was using a lancet. She was agreeable, and I began. I pricked the area numerous times with the lancet, then quickly cupped it. What I saw then was one of the most fascinating things I have ever witnessed.

The blood working its way into the cup was a solid black mass, more like a thick winding black worm than anything liquid. As this worm grew and grew, filling the cup, I was blown away by how MUCH of it there was-where was all of this stuff coming from? Most of me was in awe, and part of me wanted to vomit. As I watched, the "worm" began to turn from black, to black-red, to dark red. Finally, normal, bright-red blood began to enter the cup. I popped it off (careful not to spatter blood everywhere), and rushed to the clean-up area to revel in my vile creation. When I came back to the patient, she was sitting straight up, her neck no longer bent to the side. I could not believe it. She had color in her face, she was upright and actually smiling, and she told everyone on the way out how good she felt after that session. In the hallway, a schoolmate just stared, transfixed, as he mouthed "Why isn't she crooked anymore?" to me under his breath.

After that day, I used Ranchi Ho frequently. Somehow, though, as the years went on, I began to replace it with other techniques. Over the past few weeks, I've begun to incorporate it again, and I regret not using it more often. It's a more intense type of treatment, but the results can be so dramatic. It is great for sleep issues, anxiety, and those stubborn knots that can't ever seem to get worked out. Not everyone expels thick strings of demonic goo like that patient did, but most people with very old, deep-seated knots or injuries will produce very dark blood that slowly changes color as the fresher blood is free to circulate. It's not for everyone, but for those who need it, it can be magical!


The Liver, The Spleen, and Boundaries

As I've mentioned endless times before (although not for a while-sorry for the blogging hiatus!), acupuncturist treatments do not just deal with the physical. To be honest, creating physical change is the least exciting part of what I do. I find the mental-emotional aspects of acupuncture to be far more fascinating and rewarding; this is probably why I love treating anxiety, depression, and insomnia so much. Lately I've been thinking a lot about boundaries. A few weeks ago, I was making plans with my boyfriend and this thought quickly flitted through my mind: "I have never lied to you." As the thought surfaced, I gave myself a moment to consider what it meant, because I typically do not lie. After pondering it further, I realized that what I really meant was that I have never felt the need to say something to him that I didn't truly mean. If he asks me if I want to do something I don't want to do, I'm perfectly fine with simply saying no. I'm not sure if this is due more to my stronger boundaries that have come with age, or to our mutual comfort level with each other. It's probably a little of both.

In TCM, the Liver energy governs boundaries, while the Spleen is basically the people-pleasing, pushover side of us. I'm much more of a Spleen personality, but as we all know, acupuncture is about balance. The Liver and Spleen are the opposite sides of the spectrum, and the trouble lies when they don't meet somewhere in the middle. Too much Livery energy creates an uptight, rigid mentality that cannot bend. Excessive Spleen energy can lead to a doormat who eventually feels resentful and exhausted.

I can't tell you how many times I have treated patients for issues unrelated to boundaries and had them later tell me that this was the first time they started to feel empowered enough to say no. Or how many times I've had total Type A's come back looking like completely different people, relaxed and mellow. Yet another amazing part of this medicine.

As previously mentioned, I have always struggled with that Spleen-type, can't say no persona. Balance is hard! On the one hand, I genuinely like helping people out. However, it's sometimes hard for me to discern who is deserving, and who is taking advantage.

A few years ago, I was contacted by a local small business owner who requested a meeting with me to help with marketing techniques. I have a very visible online presence, and I am often approached by people new to business who ask for advice in this area. I am always happy to help out fellow small biz owners, and it makes me happy to give back, so everyone wins!

This particular woman set up a consultation with me, but did not want to come to my office, so I drove to her. After talking to me for over an hour about how slow her business was, I offered some tips to increase her online presence. She didn't look happy and barely listened as she doodled on a note pad. Finally, after several uncomfortable minutes, I came right out and asked her: "What exactly is it the purpose of this meeting? Is there something in particular you need help with?"

"Yes," she replied, "What I'm looking for is a way to reach more people and advertise for free, and I noticed that you show up everywhere online. I'd love it if you could link me on your website and maybe write a blog about me? And if you could put my cards in your office and talk me up to all your clients, that would be great."

I was rather taken aback by this, but again-typical people-pleaser. "Ok," I said, "I'll be happy to cross-refer. I'll leave my cards here, you can give me a stack of yours, and we can both promote each other."

I could not believe what she said next.

"Actually, I already see an acupuncturist that I love, and I refer my clients to her. Putting your cards out or promoting you would be a conflict of interest. I won't be doing that."

Bear in mind that I had driven 20 minutes to help this woman I had never met, taking 2 hours out of a busy day. I was speechless. I took her cards, left, and promptly tossed them in the garbage, vowing to screen my next request for help more carefully.

Driving back to my office, I felt completely drained. Why had I let her take up so much of my time? Damn my weak Spleen! I vowed to work on this, and I have. I'm a different person than I was then, and I'm so much happier now. Part of it is having the desire to change, yes, but I also credit my acupuncturist for all his hard work on my poor depleted Spleen. I think my doormat days are finally behind me!


Bah Humbug

I just hadn't been feeling the Christmas spirit this year, and I'm not sure why. Usually around this time I can't wait to create some boozy holiday cookies (my rum balls are infamous) and decorate Charlie, my acupuncture mascot, with a well-placed sprig of mistletoe. This year? Maybe it's the 60 degree weather in December, but meh. Growing up, it was the running joke that my father would unfailing pick the saddest, cheapest, most pathetic excuse for a tree. Every year it was something different; one year we ended up with a tree that was, technically, a bush. It was short, squat, and round. Most years, our tree looked as if it desperately needed Rogaine; Charlie Brown's tree had nothing on ours. And since the trees he picked were always at death's door, my poor mom would spend the majority of her days leading up to Christmas madly vacuuming up piles of pine needles.

Bearing witness to all this mess and inconvenience led to my decision that, for adults, Christmas trees are an unnecessary evil. I don't have children, therefore, there is no reason to spend money on what is essentially a giant stabby plant with an incredibly short life span. I am 40 years old, and have never had a Christmas tree. Until now.

This Saturday I was on my way to a restaurant right around the corner from my house when I was approached by a wildly enthusiastic man who was selling the last of his Christmas tree stock. I stood firm: no tree.  He lowered the cost from $60 to $20. I took a look at these trees that were left and had to admit that $20 was a great deal. They were so full and lush! Even as he spoke of the high school kids that would be benefiting from the money raised, I still refused to entertain the notion. Until he spoke a few magical words...

"I'll even bring it right to your front door for you!"

What can I say? That offer was far too tempting to refuse. While he left with the tree, I headed off to Target to buy a stand and lights. For the first time in my life, I was going to decorate my home for the holidays.

When I arrived home with my goods, my boyfriend (who is all too aware of my impatience when it comes to this sort of thing) was already prepared for tree trimming. Excited, I held up the tree while he put the stand together. It was too small. And broken. Target: 1, Marisa: 0. I briefly thought about returning it, realized that I'm far too lazy for all that work, and made the executive decision to just lean the tree back against the wall. Problem solved. Sort of.

The boyfriend: "You do know that trees need water to live, right?"

I hadn't really thought about that. Dammit. But soon, another idea came to mind.

Which is why I now have a drunken, tilted Christmas tree propped precariously against a wall, perched inside a blender filled with water. Merry Christmas!



What Drives You?

A huge component of my hypnotherapy practice is finding what motivates and inspires people to create change in their lives.  If you think that unhappiness is the ultimate motivation, you are wrong-at least in my experience. Like anything else, unhappiness can become a habit, one so deeply ingrained that it is easy to reach a state of reluctant acceptance. I liken it to a cold bath: If I tossed you into a tub of freezing water it would be an intolerable shock to the system. Your first instinct would be pure fight or flight, your brain screaming "I need to get out of this water...NOW!" However, if you had been sitting in a warm bath for hours, as it cooled to an uncomfortable temperature, you'd not notice the cold nearly as much. You would still feel physical discomfort, but as your body adjusted to the temperature, it would become your new norm, and therefore bearable. On many websites I express my desire to act as a catalyst for change, and I like to think I do play a role in shifting patients' momentum. However, the truth is that without the will for change, I am useless. I cannot create motivation; it needs to come from within. I can only try my best to help patients to find that spark and to assist them in building it into a steadily growing flame.

This is what fascinates me, the inner workings that catalyze change. For so many, the fear of change is all-encompassing. They would rather live in that bathtub of cold water than try to figure out how to heat things up somehow. My fear is the opposite: I am terrified of stasis. I could be living a life that anyone would envy: financially settled, healthy, surrounded by people I care about, and for a while contentment would reign. But inevitably, the same old disenchantments and fears would surface, that question that seems to be the theme of my very soul: "What's next?"

This is my motivation for change: this idea that nothing is permanent and that anything less than constant forward momentum is unacceptable. This, and my sometimes unlovely desire to prove everyone wrong who claims that I can't do something. The greatest accomplishments in my life have bloomed from a "no." Each time someone tells me that I can't or shouldn't do something, my desire to succeed grows stronger. Due to my aversion to boredom and my stubborn refusal to turn down a challenge, my career path has taken many twists and turns throughout the years, and I highly doubt that things will ever change in that regard. In fact, as blissfully happy as I have been with the way my practice is going, that little voice has yet again cropped up, whispering that it is time for the next thing.

And so I began to really think hard about what it is that I ultimately do here, and what else I could do to bring things to another level. In the midst of all this contemplation, one of my favorite patients came in and as we chatted, she told me that she could sense lately that I'm searching for something. I agreed, and she asked me why I wasn't doing anything about it.

Without thinking, I blurted out, "Because I feel like a spoiled bitch."

Like all truths, it came boiling up to the surface so quickly that I had no time to censor myself. It just spewed out in a moment of brutal self-awareness: I realized that I had been craving something more, but I was holding myself back. Why? Maybe because to continue searching while I'm living the dream of being able to support myself doing something that I adore seems like the ultimate in ingratitude. Maybe because it feels like I'm spitting in the face of good fortune, and how dare I look for something different when most people would kill to be in my position? That slowly simmering state of malcontent that had been brewing for months felt like my inner bratty child, one who had gotten all of the toys she wanted and now couldn't appreciate them.

I love my patients. I love that I learn as much from them as they learn from me. Because the next thing she said was, "You are totally looking at this the wrong way. Don't feel bad because you want more. You need to look at the changes you want to make as a way to help even more people than you are now. It's not for you, it's for them."

And just like that, my perspective completely shifted.  The idea of change didn't feel selfish simply felt like the next logical step. All at once, I had clarity, and I knew exactly what the next step will be in my ever-evolving practice.  I'm keeping it to myself right now, but keep checking back for updates!