The Shen does not have Deficiency or Excess . It is not Hot or Cold. It came from Heaven, how can we say it is too much or too little, all we can say is that the mandate from Heaven is not being expressed well, or freely, in the person, that it is being distorted and thus causing suffering. The Yi is what will most commonly restrain the Shen, and divert the Shen. Thus the great suppressor of the free expression of the Shen is the Spleen not the Heart.
There is a standard in the TCM world in which most mental-emotional problems are described as either a Shen disturbance or resulting from non-smooth Liver Qi. Common herbal protocols are to smooth Liver Qi, descend the Yang, clear Phlegm, or nourish Heart Blood, and acupuncture treatments usually involve heart and Liver points. In this article I try to offer some different ways of thinking, particularly ways to diagnose the Shen (神) through what we actually find in the body (Shen - 身), so that we can have more options at our disposal.
In looking at one of the most popular formulas for treating the Liver and emotional distress, Xiao Yao San, we see that although the formula claims to smooth the Liver, it is actually nourishing the Spleen to produce blood which will sooth the Liver by soaking/moistening it, yet we call it a Liver formula. I believe that the Spleen is being over-looked in modern acupuncture as a contributor and in treatment for mental-emotional disorders, and that we also neglect to consider our own era's language- involving the autonomic nervous system, the thyroid, gut function, and the endocrine system as well as how we establish our upright posture: the role of the feet, the legs, the relationship of the perineum, diaphragm and neck/throat
All emotions or mental state (unless unconscious ones, as in dementia) must involve the Yi (意), the intention. No matter what the emotion or mental state is, if it does not involve the Yi, it is an autonomic function, and might disrupt physiology, but has no consciousness to it. Any psychological treatment will eventually require that the Yi be accessed to deal with the issue. Thus a person may exhibit unconscious mental patterns that have bypassed the Yi, but shedding light on it will, by nature, involve the Spleen/Yi.
The Yi is not another “soul” like the Hun or the Po: it is the expression of the Heart – as the character indicates it is the sound of the heart, thus the expression of the heart is through the Spleen. (The Zhi, 志, the will, is also not a soul, but rather the development -之 or 士 , what arises from the heart). Su Wen 52 tells us that the Spleen is the messsenger (Shi – 使). The Spleen is associated with the Ying Qi (營) – the nourishment (where the army encampment, thus supplies, are around the fire), so it provides the substrate for the blood, the thoughts the emotions.
The Shen is what comes from Heaven, from the ancestors, and is extended (Shen 申) through us. Thus it likes a degree of spontaneity, it should not be constantly restrained and it should also not run wild. Hence the standard to express most emotional states as “Shen Disturbance” - as in the Shen not finding free flow. The Shen does not have Deficiency or Excess . It is not Hot or Cold. It came from Heaven, how can we say it is too much or too little, all we can say is that the mandate from Heaven is not being expressed well, or freely, in the person, that it is being distorted and thus causing suffering. The Yi is what will most commonly restrain the Shen, divert it from its purpose: we learn to behave in certain ways that are “socially appropriate,” or we learn “survival techniques,” and thus divert the Shen: this is a learning process that involves the Spleen/Yi even if it is unconscious. Thus the great suppressor (a Daoist might say the enemy) of the free expression of the Shen is the Spleen.
The Spleen is also the only channel that enters the “heart centre” (心中) except for the heart itself which originates here. Other meridians, even the Pericardium, connect with the network (Luo 絡) of the Heart, but not its centre. Thus it is the Spleen which will express/show the overflow of emotions that the heart space can no longer contain.
One of the most important concepts in Chinese Medicine is that the Clear Yang rises and that the Turbid Yin descends (which immediately suggests Spleen/Stomach). When this does not happen disease will manifest, and the Shen will loose its free flow. Thus we see that uprightness is extremely important as it facilitates the up and down flow. In the Heart Sutra Guan Yin (觀音) sheds light on her physical and mental bodies to see that they are inter-dependant (empty - Kong 空) and overcomes ill-being (Ku E – 苦厄). Ku, bitter, is a plant that is old and withered, and E, distress, is a pictograph of a person bent over. Thus disease is the lack of uprightness, and the antidote to it is reflection (Zhao Jian 照見). Zhao is the same as Kid 6 (Zhao Hai – Reflecting Ocean), so we can see Kid6 as a place to create the lift in the body that offers space inside it (as well as space in the heart/chest). The lift goes through the inner legs, supports the perineum, allows the diaphragm to be free, and opens space in the throat. These are the three diaphragms in the body, the main one in the chest plus the perineum and the glottis – creating the 3 Dan Tians, allowing for ascending and descending.
We are all familiar with the advise to breathe and free the diaphragm to calm strong emotions. The lifting of the perineum (similar to Kegels) also tones the nervous system, and Ujjayi breathing, constricting the glottis, allows parasympathetic feed in the vagus nerve. The opening, lifting, and freeing of these 3 areas are of paramount importance in all disorders involving the nervous system.
The lifting of the perineal “diaphragm” relates to both the sacral parasympathetic ganglia as well as to enteric nervous system, which affects the brain. We are well aware that the gut microbiome affects mood and emotions. The Ancients must have understood this also, naming Ren4 Guan Yuan (關元), the passage to the primary (that is the head – the character literally describes the head over two legs), and Ren3 as Zhong Ji (中極), the Central Pole, or the North Star, that which guides our direction in life.
The area in the Spleen channel I would like to promote here is SP3 as well as SP4. This is the area on which we stand, affecting our whole posture. The arch between SP3 and U.B.65 supports our whole being, and the plantar side of this line of Shu points, constitutes what master Maruyama termed the “Jue points.” The arch between SP3 and Kid2 is also part of supporting our upright posture. Without the activation of these areas, we wither (Ku) and sink in the chest and diaphragm (E). SP3 is named Tai Bai (太白), the Great White - white as in the sun that is rising up: SP3 represents our ability to rise and lift up the Yang. SP4 Gong Sun (公孫), Grandfather/Grandson implies making public (Gong, grandson) what is in the lineage (Sun, grandson which contains Xi, 系, the thread, to connect) – thus it is seen as the point that allows us to connect with the ancestors, with our true blueprint (our Chong so to speak).
In modern physiology, besides the Zang Fu, we also consider factors such as the nervous system, the thyroid and the endocrine system. Thus we see the importance of the neck, throat, and occiput. ST9 called Welcome Human (Ren Ying, 人迎) relects the thyroid as well as the nervous system. The SCM also reflects the nervous system, as it covers the Vagus nerve, a major parasympathetic nerve. C3, reflects the phrenic nerve which allows for the movement of the diaphragm, this affects the nervous system. The scalenes (ST11, 12 area) affect blood supply to the brain, and being breathing muscles also affect nervous tension. The occipital ridge, an area known as An Mian (安眠, Peaceful Sleep) is also an area where tension, or tissue that feels gummy or excessive, reflects the nervous and endocrine systems. The importance of the neck cannot be over-emphasized, as it is the bridge between the brain and the body. This is why Ling Shu 2 lists the neck points as equal partners to the points of the limbs (the “antique points”).
Other emotional reflexes are Ren17 (“anxiety reflex”), Ren15 (“worry reflex”), Ren9 (“sadness reflex” as well as weak Dan Tian that is not coordinated with the upper Dan Tians), T3-T9 in the back, and U.B.43.
A quick guide for releasing pressure pain on reflexes and treating various contributing conditions follows:
Ren9 – use MuShu G.B.27 (directly below G.B.26 level with Ren4), then right ST24
Ren15 – SP3 + Pericardium (check P.8: if painful use P.3 & P.5, if no pain, use either P.6 or P.4 which is 3 fingers below P.3)
Ren17 – release the lymphs first (S.J.8. & Immune points), then SP3 + Pericardium
Thyroid – use Kidney points (the thyroid is an endocrine gland and the Kidney channel
circulates, Xun 循, at the throat).
SCM tightness – use opposite S.J.5, for rapid pulse, or S.J.8 (one third below the elbow) otherwise.
Tight scalenes – use SP3, possibly add HT3, LU8 or Inner Yin (level with Liv9 on the Kidney channel).
T3-T7 – release with DU2 and S.I.9/10 area (calm down the sympathetic ganglia below it) needled towards the arm.
Occiput – use Under-3rd-Toe if nervous system related, use U.B.66 if hormonal.
U.B.43 – use Liv1 for the right, DU2 for the left.
C3 – use Liv1 for the right, Ren4/6 or SP1 for the left,
U.B.17/U.B.16 area is considered to be “autonomic nervous system Shu.” U.B.17 is the Shu point for the diaphragm which affects the nervous system. U.B.16 is Du Shu. Du, 督, is to supervise, to govern (to oversee the picking of the beans). A governor is someone who is quite powerful and active but who is under the control of, and is loyal to, the Queen (e.g. Queen Victoria gives the mandate to the governor of India). The body has two such systems that can be described as “Du” - the nervous system and the endocrine system, both regulate and activate but under the mandate of the brain (the emperor). U.B.17/16 area both reflects and treats the nervous system.
U.B.2 (which releases the diaphragm) and the Insomnia point at the centre of the heel are both considered to be endorphin releasing point and thus used in mental-emotional disorders. They demonstrate that pain is a perception and perception is affected by how we see and we how we establish our gait (step – Qiao, 蹻, the “dignity,” or tallness, of the feet)
In using these reflexes for diagnosing and the suggested treatment points, it is important to remember that these are suggestions rather than absolute dogmas. They provide us with some further insights and ideas that contribute to a fuller understanding that allows us to connect with and treat patients.
Of course, there are many more strategies and ways to look at the body as reflecting the mind, including more “esoteric” forms using the 8 Extraordinary Vessels, as well as Ghost points and the release of “entities.” While some practitioners use these by tradition, my tendency is to confirm those points with releasing reflexes in the body. The capacity of the human body-mind continuum is infinite, and our own imagination and creativity as practitioners must match that so that we are always searching, looking at what is present with an open mind, seeking clues in the body using all methods available, be they ancient, modern, physical, metaphorical, or philosophical. When we fully connect with the patient, we begin to see the clues that are part of the human heritage which the ancestral Teachers also tried to decipher, understand and transmit to us.
This post is also available in: Hebrew