3. The importance of the spirit
Chapter contents
The primacy of the spirit13
The meaning of mind and spirit14
Chinese medicine’s approach to the spirit and health15
The five shen15
The spirit and the emotions17
The primacy of the spirit
Five Element Constitutional Acupuncture is a very ‘person-centred’ style of treatment. When a patient comes for treatment, a Five Element Constitutional Acupuncturist is more likely to consider, ‘how can this person be treated?’ rather than ‘how can this person’s symptom be treated?’ This is because one of the practitioner’s core values is that diagnosis and treatment should be focused on the health of the individual, rather than on the physical symptoms presented.
Chronic physical symptoms are seen as being the manifestation of the illness (biao), which stems from the root (ben). The root usually lies in the mind or spirit. This is not true for all symptoms, of course. For example, symptoms caused by physical trauma or acute infections are likely to have their ben arising from an external cause rather than from a deeper internal one.
Although a person’s most underlying imbalance can arise from body, mind or spirit, the majority of patients coming for treatment in the West are suffering primarily from an imbalance of the spirit. Around a quarter of all drugs prescribed by the National Health Service in the UK are for mental health problems (The Stationery Office, 1996). There are also huge numbers of patients who present with symptoms that have a psychosomatic component. In addition, there are a large number of substances taken for their symptom-relieving effects, such as coffee, alcohol and ‘recreational’ drugs. Stress-related absence accounts for half of all sickness from work (Patel and Knapp, 1998). A recent study of 22,000 people in the UK found that:
• 58% of people suffer from mood swings
• 52% feel apathetic and unmotivated
• 50% suffer from anxiety
• 47% have difficulty sleeping
• 43% have poor memories or difficulty concentrating
• 42% suffer from depression (Holford, 2003, pp. 2–3)
As Cicero observed long before the advent of modern lifestyles and contemporary neuroses, ‘Diseases of the soul are more dangerous and more numerous than those of the body.’ It is fair to say that today many Westerners are suffering from what seems to be spiritual malaise with much accompanying mental dysfunction.
Diagnosing and treating the whole person
A practitioner of Five Element Constitutional Acupuncture diagnoses patients by assessing which is the primary Element in distress. This diagnosis is based on various sensory signs, especially the patient’s emotional balance, facial colour, odour and voice tone. The patient’s personality is also of utmost importance. The focus is on diagnosing the balance of the Five Elements within the person rather than making a differential diagnosis of the symptoms presented by the person. As the great physician Xu Dachun described it, ‘Illnesses may be identical but the persons suffering from them are different’ (Unschuld, 1990, p. 17). This idea is also reflected in the Chinese phrase yin ren zhi yi, which translates as ‘different patients require different treatment’.
Treatment is only perceived as fully successful if patients report improvement in how they ‘feel in themselves’, as well as in their signs and symptoms. Sometimes patients are surprised to notice positive differences in how they feel even if they did not perceive anything to be ‘wrong’ with them in the first place. Five Element Constitutional Acupuncture has the ability to direct treatment to any level of the patient’s mind and spirit if that is what is required to help the patient to return to good health.
The meaning of mind and spirit
What do we mean by ‘spirit’?
Many people already have a view, albeit indistinct, of what the word ‘spirit’ means. Others do not accept that human beings have a spirit at all. The word ‘spirit’ also has many different meanings in the English language. For these reasons this topic can be difficult to discuss.
The Oxford English Dictionary lists 34 separate meanings for ‘spirit’. The one that is closest to its meaning in Chinese medicine is ‘the animating or vital principle in man’. Cicero called it ‘the true self, not that physical figure which can be pointed out by your finger’. In the Chinese language the words shen and jing-shen most closely describe the spirit, although it also encompasses some aspects of the mind. The sinologist Claude Larre described shen like this:
The shen are that by which a given being is unlike any other; that which makes an individual an individual and more than a person.
(Larre et al., 1986, p. 164)
People often equate ‘spirit’ with the spiritual and religious sides of the person. The word ‘spirit’, however, encompasses many other aspects of being. Religion, mysticism and spiritual awareness emanate from the human spirit, but so also does the desire to look at a radiant sunset, to listen to beautiful music or to achieve one’s potential as a human being. When people wake up and experience the joy of seeing a beautiful day dawning, it is their spirit that is touched by that experience. Love and compassion are expressions of the spirit.
People who have problems in their spirit struggle when under stress and have difficulties coping with their lives. This may manifest in areas such as their relationships, communication, posture, use of language or the look in their eyes (for more on this, see Chapter 27, this volume). Resignation, anguish, despair, depression, disappointment, sadness, anxiety and many other states are present to some extent in almost all of our patients. As Thoreau said in Walden, ‘the mass of men lead lives of quiet desperation’.
What do we mean by mind?
The mind is the cognitive faculty and gives people the ability to think. This includes being able to concentrate, remember, plan and make decisions. The phrase ‘mentally ill’ is legitimately used in Western medicine to describe problems in sense perception, personality, emotions or behaviour. This use of the word goes far beyond the core meaning of the word ‘mental’. Many people in psychiatric hospitals have extremely astute and able minds. It is their spirits that are in distress.
In the context of Chinese medicine, symptoms on the mental level include being obsessed, forgetful, indecisive, unable to concentrate, disorganised, muddled, vague, inarticulate, dyslexic, etc. In Chinese medicine the mind and spirit are considered to be an aspect of the person’s qi. Just as qi is present in every cell in the body, so also is the person’s mind and spirit (see Pert, 1999).
The shen in Chinese medicine
Several different words are used in Chinese medical texts to describe the mind and spirit. Shen is most commonly used and it has different meanings according to the context in which it is used. Some writers translate it as ‘mind’ (see Maciocia, 2005, p. 109), some as ‘spirit’ (see Kaptchuk, 2000, p. 58) and some as ‘spirits’ (see Larre and Rochat de la Vallée, 1995, p. 4). Spirits is used to emphasise that the shen is more than just the spirit of the Heart (see below) but also describes the ‘whole sphere of emotional, mental and spiritual aspects of a human being’ (see Maciocia, 2005, p. 109). In this sense of the word shen includes the mental and spiritual aspects of all the Organs.
It is the shen that gives people their human consciousness, as the following two quotations illustrate.
To have the spirits (de shen) is the splendour of life. To lose the spirits (shi shen) is annihilation.
(Su Wen, Chapter 13; Larre and Rochat de la Vallée, 1995)
Let me discuss shen, the spirit. What is the spirit? The spirit cannot be heard with the ear. The eye must be brilliant of perception and the heart must be open and attentive, and then the spirit is suddenly revealed through one’s own consciousness. It cannot be expressed through the mouth; only the heart can express all that can be looked upon. If one pays close attention one may suddenly know it but one can just as suddenly lose this knowledge. But shen, the spirit, becomes clear to man as though the wind has blown away the cloud. Therefore one speaks of it as the spirit.
(Su Wen, Chapter 26; Veith, 1972)
The ability to perceive the nature of the imbalances in a person’s mind and spirit is important and is one of the crucial skills the practitioner of Five Element Constitutional Acupuncture strives to develop.
Chinese medicine’s approach to the spirit and health
The emphasis on enhancing the health of the person’s spirit above all else is consistently referred to in the early classics. For example:
When the Spirits are overwhelmed, they leave; when left in peace they remain. Thus the most important thing in the conduct and treatment of a being is maintenance of the Spirits, and then comes maintenance of the body.
(Zhang Jiebin; quoted in Larre and Rochat de la Vallée, 1995)
When the spirit is master, the body follows and a man prospers. When the body is master, the spirit follows and man is degraded.
(Huainanzi,Chapter 1; Larre et al., 1986)
These passages emphasise that the health of the spirit and mind is regarded as being of ultimate importance. Most people face a struggle with illness at some time in their lives. Their prognosis is often dependent on the condition of their will and spirit. It is well known that when a person gives up and ‘turns his face to the wall’ the end is not far away. 1
The essential point in the treatment of an illness is to root oneself in the five spirits of the person: to know whether they dwell or have been lost, whether one possesses or loses them, to know if the intent is for death or life.
(Taisu; Larre and Rochat de la Vallée, 1995)
How can a disease be cured if there is no spiritual energy left in the body?
(Su Wen, Chapter 14; Veith, 1972)
When one applies medical treatment, one must keep in mind first of all, the patient’s spirit
(Ling Shu, Chapter 8; Sunu, 1985)
In order to make all acupuncture thorough and effective one must first cure the spirit
(Su Wen, Chapter 25; Veith, 1972)
Using acupuncture to treat the spirit
At the time of the Nei Jing and Nan Jing, the period when Daoism’s influence on Chinese medicine was at its height, acupuncture was the form of therapy most discussed. The Ling Shu is solely concerned with acupuncture. With its ability to influence the person’s qi in the channels acupuncture was regarded as the primary therapeutic modality for initiating change in a person’s spirit and mind.
If the body is healthy and the xin (Heart-Mind housing the Spirit) suffers, illnesses arise in the meridians (channels). Moxa and needles are the proper treatment.
(Su Wen, Chapter 24; Unschuld, 1992, p. 293; additional translation of xin by Claude Larre)
Five Element Constitutional Acupuncture continues the tradition of regarding the health of the mind and spirit as being of prime importance. Acupuncture and moxibustion are profoundly effective therapies for treating these levels in a person.
The five shen
The word shen is used in two ways. As discussed in the section above, one use encompasses the ‘whole sphere of emotional, mental and spiritual aspects of a human being’. Although a person’s spirit is ultimately indivisible, the Chinese also discussed it in terms of five different ‘spirits’ which interact together. Each of the spirits is responsible for a different aspect of the person and is also associated with one of the yin Organs. In this context shen describes the ‘spirit’ of the Heart specifically. This is used alongside the hun, po, zhi and yi, which are the spirits of the other yin organs (see Table 3.1).
| Organ | Spirit | Translation |
|---|---|---|
| Heart | shen | mind/spirit |
| Spleen | yi | intellect/intention |
| Lungs | po | corporeal soul |
| Kidneys | zhi | will/drive |
| Liver | hun | ethereal soul |
In many ways the five shen are closely linked to the ‘Officials’ described in Su Wen,Chapter 8 (see Chapter 2, this volume). Both describe important aspects of the spirit. Some of the shen, especially the hun and the po, also describe the spirit in relation to life and death. This is of interest, although of less use diagnostically, to a practitioner.
An overview of the five shen
The following is an overview of each of the five shen. They are described in more detail in Section 2 of this volume.
Hun
The hun of the Liver or Ethereal Soul is most closely linked to what in the West is called a person’s ‘soul’. The hun is said to enter the body at birth and to leave the body and continue on when a person dies. When people relate that they have separated from the body, for example, during ‘out of body experiences’ or ‘near death experiences’ (Moody, 1973) or if people sleepwalk or are in a trance, these experiences involve the hun. Strengthening the spirit of the Liver can help to keep the hun in the body if this is pathological. In less extreme cases people can become rather vague and day-dreamy.
Also useful diagnostically is the fact that the hun is associated with people’s ability to fulfil their life plan as well as their ability to have spiritual vision or insight. If a person constantly has dreams, either in the form of dreams during the night or daydreams or just being rather vague or ‘spacey’, this may be due to an imbalance in the Liver that affects the hun. This is often noticeable in people who have taken significant amounts of recreational drugs.
Po
The po of the Lung or ‘corporeal soul’ is an exclusively Chinese concept. It is an aspect of the spirit associated with the physical body and it dies when the body ceases to function. The po allows people to have instinctive reactions, for example, the ability to put out a hand to catch something while in flight. It also enables people to become animated. For example, when a person becomes ‘spirited’ or excited, the Chinese use the term ‘po li’. This describes someone who is vigorously involved in an activity (see Yang, 1997, p. 293).
The po is closely aligned to a person’s breathing, which is called ‘the pulsation’ of the po. Good breathing roots the po into the body and allows people to feel more animated or alive. The po also gives people the ability to feel bodily sensation. Weak Lungs cause them to be less able to register physical sensations arising from such things as feeling, seeing and hearing. In consequence people may start to become distanced, inert or cut off from others when the Lungs are out of balance.
Shen
The shen of the Heart or the mind/spirit aligns a person’s consciousness to the world and allows her or him to communicate with others. It is the most visible of the spirits as it allows people to think clearly and act appropriately in social relationships as well as be settled and calm in order to relax and sleep. The state of a person’s spirit generally and especially of the Heart itself is reflected in the brightness of the eyes and a person’s ability to make eye contact with others.
Zhi
The zhi of the Kidney is often translated as the will or drive. It has been called the ‘will that can’t be willed’ because it allows people to move forward in their lives without consciously pushing or driving themselves. A person with strong Kidneys will reflect a strong Kidney spirit by having a ‘drive to be alive’. Conversely people with less strong Kidneys may have a lack of drive or may overcompensate for their lack by pushing themselves overly hard and appearing to have extreme drive or strong willpower.
Yi
Finally, the yi of the Spleen is sometimes translated as the intellect or ‘intention’. The yi allows us to bring our thoughts and ideas to fruition and make ideas manifest in the world. When the Spleen is weak a person is unable to accomplish things and may feel unfulfilled by what they do. The inability to bring things to fruition has been termed being ‘unable to reap a harvest’. This is a term often used by J. R. Worsley when diagnosing Earth CF patients.
The spirit and the emotions
The spirit is affected by a person’s intense and longstanding emotions. Although the effect is on the patient’s shen, hun, po, zhi or yi, the practitioner will often state this in terms of needing to treat the ‘spirit level’ of the Element. For example, a practitioner who thinks that the patient’s spirit has been damaged by intense grief, will focus attention on the spirit level of the Metal Element. The practitioner is always striving to bring about balance between the emotions resonant with each of the Elements. The Han dynasty text, the Zhong Yang, describes this:
The state when the emotions are aroused and relaxed, each attaining its appropriate measure, limit and articulation, is called harmony.
(Davis, 1996)
Summary
1 Focusing diagnosis and treatment on the health of the mind and spirit is a core principle of Five Element Constitutional Acupuncture.
2 The Chinese word shen describes both the mind and spirit of a person. It gives people their human consciousness.
3 Each Organ has a spiritual aspect. The names of these are the shen (mind/spirit), hun (ethereal soul), po (corporeal soul), zhi (will/drive) and the yi (thought/intention).
