| |
|
|
bipolar
disorder
FIVE-ELEMENT
ACUPUNCTURE
FOR HUSBAND-WIFE IMBALANCE
AND BIPOLAR DISORDER
Charles A. Moss, MD
ABSTRACT
The Law of Husband-Wife, a component of Five-Element
acupuncture, illustrates the energy balance
between the Elements, represented in the left
(Husband) and right (Wife) radial artery pulses.
Often patients with chronic and/or severe
illness or stress manifest disequilibrium
of the Husband-Wife balance. The following
case report details the identification and
treatment of this energy blockage in a patient
with bipolar disorder.
KEY WORDS
Five-Element Acupuncture, Bipolar Disorder,
Husband-Wife Imbalance, Pulse Diagnosis
INTRODUCTION
The concept of blocks
in the movement and balance of energy is implied
in all traditional acupuncture systems. Five-Element
acupuncture is a traditional system organized
around the movement of energy through the
Elements along the Shen (creative) and K'o
(controlling) cycles (Figure
1).1
In Five-Element acupuncture, there are several
unique concepts that describe energetic blocks,
including Aggressive Energy, Internal and
External Devils, and the Husband-Wife imbalance.
The Husband-Wife imbalance is frequently encountered
in patients with chronic physical symptoms
or significant emotional stress. It can also
occur in generally well-compensated people
in times of chronic or acute stress. To understand
the Husband-Wife imbalance, the Law of Husband-Wife
first needs to be explored.2
Law of Husband-Wife
A fundamental
energetic equilibrium exists between the 6
Yin-Yang pairings of the Officials, which
are represented in the radial pulse at the
wrist. (In Five-Element acupuncture, the term
Official describes the entire range of functional
correspondences of each organ and its meridians.)
The 3 paired pulses of the left hand, the
Husband Officials, are Bladder and Kidney,
Gall Bladder and Liver, and Small Intestine
and Heart. The 3 paired pulses of the right
hand, the Wife Officials, are Three Heater
and Master of the Heart, Stomach and Spleen,
and Large Intestine and Lung.
As a reflection of
the functions of the Elements, the energy
of the Elements and Officials represented
in the left-hand pulses (Husband) should be
greater in quality and quantity than the energy
of the Elements and Officials of the right-hand
pulses (Wife). This is a law of nature that
applies to both sexes. In this context, the
Elements and Officials are reflecting the
energetic dynamic that is essential for the
healthy functioning of the body-mind-spirit
and the maintenance of the life force. The
graphic representation of the Law of Husband-Wife
includes a vertical line (running from north
[below], to south [above]), that divides the
Five-Element circle into 2 halves, and reflects
how the energy system is represented in the
pulses (Figure 2).3
The energy systems represented by the left-hand
(Husband) pulses, Water, Wood, and left-hand
Fire (Heart and Small Intestine Officials),
create the movement from winter to spring
to summer, and are the ascendant Yang energies
of birth, rebirth, regeneration, repair, and
healing. These are the Yang energies of the
creative, motivating, expanding, and activating
energies of "Heaven," and in the maintenance
of life, they have to be slightly stronger
than the receptive energies represented in
the right-hand pulses.
The energy systems
represented by the right-hand pulses (Wife),
right-hand Fire (Master of Heart and Triple
Heater Officials), Earth, and Metal, create
the movement from summer to late summer and
then, to fall, reaching the winter solstice.
These are the Yin energies of "Earth" (in
the Earth/Heaven dichotomy), which are more
dense, catabolic, downward, and inward moving
(Figure 3). The Table
summarizes the qualities of the Husband Officials.
The 3 Husband Officials,
in effect, are the seats of the key physical,
emotional, and spiritual resources for healing.
The qualities these Officials represent in
the healing process are frequently seen as
the critical factors in the profiles of people
with successful outcomes in serious and life-threatening
illnesses. In a situation in which these energies
collapse, such as chronic stresses or acute
crisis, the individual can enter a spiral
of disintegrative influences and quickly move
into serious health problems.
The Elements and Officials in the Wife side
of the energy system, Fire, Earth, and Metal,
relate to aspects of immunity, circulation,
nutrition, assimilation, oxygenation, and
elimination. They relate to love and relationships,
self-nourishment and acceptance, self-esteem,
and the release of old, stale energies. In
the emergence of a Husband-Wife imbalance,
these Elements and Officials can become hyperactive
and unbalanced , This hyperactivity, as well
as a collapse of the left-hand energies, is
often responsible for the genesis of the Husband-Wife
imbalance.
The 2 sides tend
to respond differently to chronic stress.
The left-side, upward moving, and Yang energies
can become exhausted, collapsed, and resigned
from chronic stress or a series of acute crises.
The right-side, downward, denser, Yin energies
grow and compress as stress accumulates, increasing
to a hyperactive state. At a certain critical
point, due to the interconnecting links of
the Elements and Officials, these shifts and
disturbances move through the system, establishing
the Husband-Wife imbalance.
|
Table. The Left-Side (Husband)
Yin Officials
|
| Kidney |
Liver |
Heart |
| Water |
Wood |
Fire |
| Winter |
Spring |
Summer |
| Adrenals,
bone marrow |
Wei Chi, detoxification |
Circulation,
blood, immunity |
| Will for survival,
constitution, strength and power,
Jing activity, fear and fearlessness |
Anger (action),
fight for self (Wei Chi), ability
to reorganize and heal |
Love and self-love,
joy, creativity, overall control of
healing by relaxation and integration |
| Zhi |
Hun |
Shen |
| "Will" |
Manifestation
of our true path and destiny |
Essential
higher self |
| Faith: in ourselves and
our healing |
Hope: our sense of a future,
future plans, new possibilities for
healing |
Spirit: connection with
life and healing |
REPORT
OF A CASE
The patient was a
41-year-old white woman with a 20-year history
of bipolar disorder. Her current medications
included lithium, 300 mg, and effexor, 25
mg. Her first manic episode occurred at age
21 years, and led to hospitalization and subsequent
treatment with lithium. She has had numerous
manic episodes since the onset of the illness.
In the past, if she recognized the onset of
a manic episode, she would increase her medication
dosage. The response to the medications often
would take several weeks to occur, during
which time she would become dysfunctional,
unable to work, and experience significant
difficulties in her relationships.
We initiated a course
of Five-Element acupuncture when there was
a moderate degree of lability in her mood.
After 2 treatments, including clearing Aggressive
Energy (see below), and treating points on
Small Intestine (her root constitutional factor)
and Heart, she reported that she was clearly
entering a manic phase. She had slept very
little for several days, was writing incessantly,
and had not been able to work. She had not
yet increased her medication dosages to treat
the mania.
When seen for her
third treatment, her pulse diagnosis had dramatically
changed. The right-hand pulse, including Lung,
Colon, Spleen, Stomach, Master of Heart, and
Triple Heater, had a full, aggressive, hard,
tight, and hyperactive quality; the left-hand
pulse was uniformly deep, deficient, empty,
flat, and collapsed. She appeared mildly agitated
and talked very rapidly with pressured speech.
She brought in a detailed diary of her previous
week, which highlighted the manic behavior
and thought pattems. Even though she was aware
that she was entering a major manic episode,
she wanted to avoid increasing her dosage
regimen if possible.
The pulse diagnosis
and her history were consistent with a Husband-Wife
imbalance, which correlated with the onset
of the manic episode. The treatment was aimed
at tonifying the lefthand pulses, particularly
Kidney, Bladder, Small Intestine, Heart, and
Liver, by transferring the excess energy from
the right-hand pulses, specifically Colon,
Lung, and Spleen. The points chosen were used
in traditional tonification technique in the
following order bilaterally: Bladder 67, Kidney
7, Kidney 3, Liver 4, Small Intestine 4, Heart
7, and direct moxibustion and needling of
Kidney 24. The treatment had an immediate
effect on the pulse pattern with the clearing
of the abnormal quality and hyperactivity
of the right-hand pulses, and significantly
increasing the overall energy of the left-hand
pulses.
The treatment had
an immediate calming effect. The manic episode
disappeared within 24 hours. Her emotional
lability improved and she felt a significant
increase in her sense of emotional and mental
stability. This was the first time that she
was able to resolve a manic episode quickly
and without increasing her medication dosage.
When she was seen I week later , the pulse
diagnosis confirmed that the Husband-Wife
imbalance was resolved, and the ongoing treatment
of her root factor was resumed.
DISCUSSION
Bipolar disorder
is a common psychiatric illness with an incidence
of 0.4% to 1.6% in the general population.
It is characterized by recurrent manic episodes
in more than 90% of patients with this diagnosis.
Lithium tends to reduce the incidence of manic
episodes, although there is a wide range in
the frequency of recurrence. The average person
has 4 episodes in 10 years, although some
are described as rapid cycling and have frequent
episodes. Most people are fully functional
between episodes; however, up to 30% of patients
with bipolar disorder continue to experience
mood lability and interpersonal difficulties.
The occurrence of
the Husband-Wife imbalance at the onset of
a manic episode has not been reported previously.
The coincidence of the Husband-Wife imbalance
with the onset of a major manic phase is of
great interest. It is possible that the energetic
dysfunction contributing to a manic episode
is frequently this major energetic block.
The patient's behavior during a manic phase
can be interpreted in the context of the Husband-Wife
imbalance. She described herself as being
driven by a force that feels like a whirlwind,
and having a "manic monster" constantly controlling
her mental state. This correlates with the
breakdown of the energetic balance of the
Law of Husband-Wife.
In the Husband-Wife
imbalance, there is a reversal of the normal
dominance of the Husband Officials (Kidney,
Liver, and Heart as the Yang ascending and
expanding energy) in relationship to the Wife
Officials (Lung, Spleen, and Master of Heart
as the Yin, descending, grounding, and stabilizing
energy).4
The symptoms seen in this patient of the dominance
of the manic behavior over her normal personality
are a clear example of the outcome when the
Husband-Wife energetic pattern is disrupted.
In this case, the domination of Wife energy
leads to a loss of emotional control and a
distortion of the patient's personality, which
can lead to a loss of normal function on any
level, including mental, physical, and spiritual.
The inability to reorganize the energetic
architecture and to recover from stress in
a normal fashion, which in this situation
led to the manic episode, is a frequent occurrence
in the Husband-Wife imbalance.
The development of
the Husband-Wife imbalance is not uncommon
in the population seen in a medical acupuncture
practice. The etiology of the Husband-Wife
imbalance includes a variety of circumstances
with a consistent theme of high-level stress
- due to a sudden event such as an accident,
an assault, or the death of a loved one, or,
more commonly, from a gradual breakdown of
the ability to adapt and cope with stressors.
The Husband-Wife imbalance can occur in patients
who are being treated with acupuncture who
suddenly begin to regress or decompensate.
A Husband-Wife imbalance can occur in any
patient and is not dependent on certain diagnoses
or complaints, although it is more likely
in seriously ill patients.
It is also common
to see this problem emerge when people are
struggling with different aspects of their
inner self. A typical example would be a woman
who has career ambitions, but finds herself
in a role such as homemaker and resents the
limitations. Her Husband energy, which is
to be expansive, creative, and Yang, is overcome
by the necessity to nest and pull inward,
which augments the Wife energy. This disequilibrium.
appears frequently from the stress of relationships
that are out of balance, a literal Husband-Wife
imbalance. There often can be a Husband-Wife
imbalance in serious illness when there is
a rapid deterioration in either the mental
or physical condition of the patient.
The movement of the
energy through the Shen cycle requires the
movement from Metal to Water, and Fall into
Winter. This part of the circle of life is
a time of moving deeply within, releasing
loss and grief (Metal), and connecting to
our deepest nature in Water. If we are not
able to let go and resolve our issues in Metal,
the energy will not be able to move into Water
to initiate the cycle of renewal, which starts
in Winter and moves into Spring with the Wood
Element. It is the "breaking" of the energy
circle that leads to further disruptions and
the inability to recover from physical, emotional,
or spiritual challenges. Spiritual despair
can be very profound as a loss of belief in
oneself and in one's sustaining beliefs and
values.
The Husband-Wife
treatment can reconnect the movement through
the Shen cycle and restore the equilibrium
between the Husband and Wife energies. Once
reestablished, the patient has a greater chance
to improve with the subsequent treatment course.
The Husband-Wife treatment will, at times,
have to be repeated if the pulse diagnosis
reveals the same pattern recurring. Although
this treatment is traditionally used in the
context of Five-Element Acupuncture, if done
precisely, it can be interspersed with other
acupuncture treatments. The Husband-Wife treatment
should be the only one done at the time, with
the patient returning within I week to assess
the pulse and repeat the treatment if required.
The diagnosis
of the Husband-Wife imbalance is dependent
on the pulse diagnosis and the history, appearance,
and presentation of the patient. Indications
of the Husband-Wife imbalance, as noted previously,
include a change in the severity of symptoms,
no response to treatment, giving up, agitation,
a sense of hopelessness, and the inability
to overcome relationship or social stress.
Patients may have lost faith and trust (Water),
their inner truth and vision (Wood), and the
connection to their passion and love and self
(Fire). The key to diagnosis is the imbalance
presented in the pulse diagnosis.
TREATMENT
The treatment of
the Husband-Wife imbalance involves a set
sequence of points using the tonification
technique of Five-Element acupuncture. The
tonification method involves a rapid insertion
of the needle into the acupuncture point,
recruitment of the Chi sensation, a clockwise
180' turn, rapid removal, and sealing of the
point. The treatment can be used at any point
in the course when a Husband-Wife imbalance
is suspected. It is necessary to test and
treat Aggressive Energy prior to using the
Husband-Wife treatment. Aggressive Energy
is treated by placing needles superficially
in the back Shu points of all the Yin organs
and watching for erythema. If the erythema
is at least 7 mm in diameter, the needles
are retained until the redness clears. The
practitioner may then proceed with the Husband-Wife
treatment on the next visit.
The goal of the Husband-Wife
treatment is to restore the left-right pulse
balance through taking energy from the Wife
side and pulling it to the Husband side, restoring
the Yin-Yang balance. It is common to repeat
this treatment over several sessions if the
effect does not persist as measured by the
pulse diagnosis. The treatment sequence is
as follows:
-
Tonify the Metal points of Water to bring
energy from Metal to Water (BL 67 and
KI 7).
- Tonify
K1 3 to bring energy from the Earth to
the Kidney.
- Tonify
LR 4 to bring Metal
into Wood.
- Tonify
the source points of Small Intestine and
Heart (SI 4 & HT 7). This is not an energy
transfer as such, but it does touch on
all the left-hand Elements. These 2 key
Fire Officials are needed to complete
the transition from the chaos of the Husband-Wife
block. The Small Intestine allows a clear
sorting of the pure from the impure elements
of the person's life; the Heart, the Supreme
Controller, is restored to the position
of being in command of the individual's
life process. The source point HT 7, Spirit
Gate, opens into and recon nects the person
back to the light of his/her spirit. As
such, it is a completion of the reawakening
of the Elements and Officials of the left
side.
- To
complete the treatment, use 5 direct moxas,
and then needle KI 24 (Spirit Burial Ground),
restoring the connection with the patient's
"buried spirit." In effect, this treatment
resurrects the spirit to sustain and illuminate
the life process.
CONCLUSION
Five-Element acupuncture
is a powerful tool for deep transformation
and restoration of the normal energetic architecture
of the body, mind, and spirit. Treatment of
the major energetic disruptions, such as the
Husband-Wife imbalance, can be lifesaving,
helping the person regain his/her life's path.
The pulse changes that reflect the HusbandWife
imbalance imply that the person was not able
to restore energetic equilibrium with normal
homeostatic mechanisms. In a person with energetic
resilience, the Husband-Wife imbalance can
frequently self-correct with any well-designed
acupuncture treatment that effectively brings
balance to the energetic system. However,
when the depth of the imbalance prevents a
response, the specific HusbandWife treatment
is required. This treatment can be included
in other acupuncture systems as well, but
needs to be used as a free-standing treatment.
Manic-depressive
disorder is a graphic example of the disruption
of the Law of Husband-Wife. However, it is
not possible to assume that all patients with
manic-depressive disease require, or will
benefit from, this treatment. The fact that
the Husband-Wife changes correlated with the
onset of a manic episode warrants further
documentation. In general, the most effective
acupuncture treatment is individualized for
the patient's specific constitutional pattern.
REFERENCES
1. Moss C.
Five elements and medical acupuncture. AAMA
Rev. 1991; 3(2):21-26.
2. Worsley JR. Traditional
Acupuncture. Vol 2: Traditional Diagnosis.
Royal Leamington Spa, United Kingdom: College
of Traditional Acupuncture; 1990.
3. Moss C, Puhky R. Five Element
Acupuncture for Physicians [syllabus]. San
Diego, Calif-, September 1998.
4. Eckman P. In the Footsteps
of the Yellow Emperor. San Francisco, Calif:
Cypress Books; 1996.
AUTHOR
INFORMATION
Dr Charles A. Moss is in private practice
in La Jolla, California, specializing in Medical
Acupuncture, Integrative Medicine, and Family
Practice. Dr Moss is Co-Director of the Five-Element
Acupuncture for Physicians Training Program,
and a frequent lecturer in Five Element Acupuncture.
He is a founding member of the AAMA.
Charles
A. Moss, MD
8950 Villa La Jolla Dr, Suite 2162
La Jolla, CA 92037
Phone: 619-457-1314 - Fax: 619-457-3615 -
E-mail: CAMOSSMD@aol.com
Back
to Top Table
of Contents AAMA
On-line
Journal Index
|
|
|
|