I have been asked many times, as I'm sure you have, As an acupuncturist, do you treat addictions? If you have answered yes, I now challenge you to think about exactly what it is that you are dealing with and the answers you have to the following questions: What is your diagnosis for an addiction? How precise, and at the same time, how broad is your scope of treatment? How do you define success in treatment? Have you discovered that traditional Oriental medicine (TOM) has more to offer than what's being shown on the surface?
Let's break down the answers to these, and related questions, by separating these articles into three parts: diagnosis one and two, and treatment. For this article, we'll examine the diagnosis, while subsequent articles will go further into theory and treatment.
DIAGNOSIS
What is an addiction and what is its diagnosis from a TOM standpoint? When we examine an individual addict, he or she will have a particular set of signs and symptoms that we, as Oriental medicine practitioners, can identify and treat accordingly. With conditions that appear as the typical Kidney, Liver, Lung and/or Heart yin deficiency, to the ever-present Liver qi stagnation, there are a vast array of TOM concerns that will show up from addict to addict. We are proud to recognize and treat the client as a unique individual, for this is without a doubt a great attribute of our medicine, but it is still not the diagnosis for an addiction. So, what are some TOM concepts that address this condition specifically and give it the proper vocabulary it deserves?
In order to come up with these answers, we must first find a way to break addiction down into manageable parts so we may examine it piece by piece. One way to accomplish this is to employ the Chinese Five Element system. This approach provides a way to view addiction's individual components based upon what happens in each particular element during the cycle of addiction.
The above chart is how I see the cycle of addiction, and it is the easiest way for me to explain this viewpoint, beginning with the element of Water. This is the place where a belief has taken hold like a seed under winter's frozen soil. This belief is what psychology would call a limiting belief or a core belief, and what we in TOM would classify as having its origins based upon a particular fear. Let's utilize an example by calling our addict "Seymour" and having him suffer from the popular fear of "I'm not worthy of love."
Seymour's fear-based belief causes uncomfortable feelings, so he naturally begins to search for some form of relief. His Wood energy decides to spring into action by taking a path to his local HMO doctor. This motion results in a Western diagnosis of "adjustment disorder with depressed mood" based upon his recent divorce (basically saying that he's got a good reason to be temporarily bummed out) and he is prescribed a little pill to help him get over the hump.
Now, this little pill doesn't promise to contain the joy that Seymour's Heart desires, but it does advertise a solution to quiet the annoying voices in his head, which remind him of all of the reasons why his wife is not coming back and simultaneously reinforce his fear of not being worthy of love. The raging, fiery pain of heartache is obvious, ever-present and even seen as a diagnosis by his doctor. This validation and the assurance of relief offered by the pill appear to be a good solution.
So, Seymour fills his prescription, takes his pills and voila, the heartache, as well as the belief, is indeed relieved. He is provided with an experience in a pill that seems to effectively control, albeit temporarily, the pain of his fear. Hmm ... nothing wrong here, right? Yep, this whole thing really has got his problem under wraps, so why even bother with that pesky original belief? Oh, maybe it's because Earth's physical remedy only controls Water's belief (through the Controlling Cycle) by providing numbness, not answers. These deeper issues at the core of his problem have not been looked at, much less solved, by this scenario. So, here now is the choice Seymour has to make in Metal: Does he have the awareness to realize and the subsequent courage to follow through on the fact that this remedy is only a Band-Aid, or does he fully buy into the illusion that it's a permanent fix?
If Seymour makes the right choice, he'll find that the temporary relief provided by the pills will open a window of opportunity, which he can then take full advantage of to get help for his emotional concerns. If he works through the pain of his problems and then tosses the prescription, he will have made the healthy, logical choice, but that's not what addicts do. As addicts, we notice that these magic little pills not only take away the pain for the originally prescribed problem, but guess what, they also work pretty darn good for just about all of our other problems. An addict depends upon the pill's experience (Earth) to control the pain of the belief (Water); daily actions are conducted from decisions aimed at relief (Wood); the desires of the Heart take a backseat to the perceived pleasure of numbness (Fire); the manifestations that are important are the experiences that provide the relief (Earth); and holding onto this cycle (Metal) is to reinforce the illusion that "this is working," which subsequently protects the original beliefs that get to remain in hiding.
We are proud to recognize and treat the client as a unique individual, for this is without a doubt a great attribute of our medicine, but it is still not the diagnosis for an addiction.
In summary, this is how the cycle of addiction works based upon the Mothering Cycle, with Seymour's specific examples in parentheses:
Water/Belief - a deep seed of fear takes hold (I'm not worthy of love).
Wood/Motion - the fear in action (the search for relief).
Fire/Desire - the fuel that feeds the fear (heartbreak).
Earth/Manifestation - the fruits of fear's labors (the little pill).
Metal/Release or Reinforce - the choice to relinquish fear's cycle of manifestation or reinforce it and hold onto the fruits (the illusion that this solves the problem).
In TOM, we can choose to work on any obvious imbalance in one or more of the phases, but this doesn't provide us with any new information about how we form a specific diagnosis. So, how do we answer the original question of, "What is the diagnosis for addiction?" First, we must recognize that there is a complete cycle at work here, and that we'll need to honor it in its entirety for diagnosis, and subsequent treatment, to be accurate and effective. This is important because the cycle is the diagnosis. Missing this point creates the disparate views of addiction often found throughout the entire health care community. It is like the old story of the blind men describing the elephant to each other, with each man believing they know what the whole elephant is about by feeling only one part. We are like them when we think we understand addiction through our examination of one particular aspect of the disharmony.
By gaining a holistic perspective of this pernicious malady, our full arsenal of compassionate approaches can be met with much greater success and allow us to heal beyond the scope of superficial symptoms. In doing this, we can learn to help our clients unravel the tightly wound threads of their familiar, old blankets of addiction, which has had them wrapped up tightly in denial and pain; and offer them the choice of a healthier future.
As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Though the creation of a financially sustainable, health-promoting model feels far away today, we are casting a vision for a full return on health, believing that this compels us to keep one foot firmly rooted in caring for the sick and the other foot firmly founded in maintaining health. Shifting from a fee-for-service model to value-based care using a phased approach is paramount.
Laser therapy has emerged as a powerful tool in the realm of traditional Chinese medicine (TCM). This new modality fits beautifully into the toolbox of the modern acupuncturist, as it can be used as a hybrid form of stimulation to acupuncture points, meridians, organs, nerves, and symptomatic areas in a new way that blends both moxa and energetic needle-like responses.
