Stillness and tranquility set things in order in the universe. Yin-like principles of meditation can be used to help patients who struggle with Yang-like health concerns for example: stress, OCD, PTSD, and anxiety to regain balance. Fire (yang) is active and consumes, water (yin) is still and nourishes. Balancing ceaseless mental and emotional activity requires stillness. Sitting still in meditation for some can be difficult, but integrating meditative techniques throughout daily routines is a practical approach that can still be rewarding. I call this "taking it with you."
There are many different meditative practices. Some patients often express that they don't know how to relax. Developing meditative skills for relaxation is a great self-care practice. Increasing awareness of the differences between relaxation and stress is fundamental to meditative practice. Based on yin yang principles to support health, we need a harmonious transition of opposites for example: rest balances activity. I consider mental stress to be an energetically dispersing and consuming state of mind. This state causes an opposing secondary reaction of constraint to maintain individual control throughout challenges in life. In the practice of Tai Ji Quan and qi gong the mind leads the qi (vital life force). Mental constraint generates qi stagnation. Stagnant qi can manifest physically becoming more challenging to cope with and treat.
Recently, I had a discussion with a patient. I was suggesting meditation for relaxation. The dialogue was riddled with frustration from the patient with comments such as "I don't know how to relax" or "I can't turn my mind off." I retreated from explaining a grand approach to meditation and decided to break it down into itsy bitsy steps. I saw the patient's eyes light up with acceptance and I decided to chronicle the event in various steps outlined in the following.
Observe differences between states of stress and relaxation
I like to ask the patient - how do you feel when you are stressed? how do you feel when you are relaxed? It is essential to make comparisons between states of stress and relaxation to develop awareness. I tell the patient to try to identify relative elements involving mind, body and breath to bring depth to self-awareness. Such relative elements may include observing posture, breathing patterns, emotions (how you feel), mind (how you think), surrounding environment, sleep, diet (what they eat and how they eat), relationships, work, daily habits and routines. The patient can compare each element through states of relaxation and stress - how is my posture when I feel stressed? how is my posture when I feel relaxed? This practice can center the mind and increase self-awareness. I also like to explain a bit of yin yang theory to every patient so they can understand analogies I will use to increase awareness and better observe such elements. For example: fire and water are elements that can be categorized as yang and yin respectively. Fire and water are opposites but in promoting wellness these elements must integrate. You can't boil water if the fire is above and not below. Fire is warming, water is cooling, fire is active, water is about rest, fire is consuming, water is nourishing. Stress is unsettling and consuming like fire. Relaxation is calming and nourishing like water. Awareness increases your ability to counter moments of stress with relaxation to maintain balance. Awareness is like a digital picture – more pixels exposes an image with more detail.
Breathing is the Strategy
In Tai Ji Quan, as a martial art the body is the battlefield, the mind is the commander of the army, qi is the army and breath is the strategy. If the mission is relaxation then the strategy relies on a deep, calming breath. I like to instruct a patient to become aware of Normal Abdominal Breathing (NAB) as a starting point. Lay comfortably in a supine position with hands crossed over your abdomen. Feel the abdomen rise on inhalation and sink on exhalation like ocean waves calmly advancing and regressing. Avoid any chest movement. Breathing from the chest is what I like to call a fire breath. Fire breathing excites the qi and causes a rising feeling in the body. We want to encourage a water breath that lowers our focus on the abdomen resulting in a settling and calming effect. On inhalation only fill your lungs to 80 percent capacity. If it is at 100 percent capacity it will cause tension and disturb your mind. In a sitting position you may slouch and obstruct abdominal movement. If your back is weak you may find it difficult to sit upright for long periods of time so a supine position will be more comfortable.
Practicing Moments of Meditation
Here's an often asked question - "When should I practice and for how long?" I always answer: "Now and then is better than never." Maybe you can dedicate some time each day to practice and maybe not, but the principles are portable and can be taken with you throughout the daily grind. The goal in this application is to make relaxation familiar. You want to take these lessons with you throughout your day. In any given moment when you feel stress be aware of the discomfort, take a deep breath and try to let it go. Be aware of the effects of stress. Observe how it constricts your breathing, changes your posture and disturbs your mind. Now practice restoring balance - adjust your posture, take a deep breath (NAB) and relax your mind - cool the fire. When I teach Tai Ji Quan in class we start off in a comfortable posture called wu ji or emptiness. In wu ji, as a gentle reminder, we say a unifying mantra to ourselves, "Calm the mind, relax the body and deepen the breath." Tai Ji Quan is part of a cycle of movement that starts and ends with wu ji. So in respect to self-awareness, applying this wu ji mantra can empower a patient with a concept to transform moments of daily stress and minimize escalating tension and stagnation.
Refine self-awareness by using yin yang theory to observe distinguishing moments of tension and relaxation. A deep, calming breath (NAB) is the strategic key to unifying, centering and relaxing mind, body and breath. Make meditation practical by applying the principles throughout your day. Taking it with you promotes frequent practice pointing the way to natural conditioning so you don't have to practice because it just becomes natural.
References
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In the past five years of my clinical practice, I have seen an astonishing upsurge in the chronic use of proton-pump inhibitor (PPI) medications for the gastrointestinal issue diagnosed by allopathic medicine as GERD. It is not uncommon to encounter patients taking these prescriptions for five-plus years.
Working with chronically ill patients entails acknowledging the reality that not all patients will survive their diagnosis. Chinese medicine and acupuncture play a crucial role in palliative and end-of-life care, addressing medication and disease side effects, alleviating pain associated with death, reducing anxiety and stress, and helping patients find peace during the dying process.
