The Role of TCM When Treating Psychological Disorders

It is hard to imagine anyone anymore who goes through life without trauma. The complications of life in the 21st century mean that there will be events that mar us emotionally. At their worst, traumas can happen during the formative years of childhood – abuse, neglect, divorce or loss of a parent, or other tragedy. Those traumas in the early years can skew the way that people frame their lives, and have profound effects on self-image, relationships, openness to new experience, and other crucial aspects of adult life.

Other trauma can occur later in life, and be as varied as an unexpected physical illness, a relationship crash-and-burn, a racist or misogynistic assault, or the like. With so much trauma affecting so many people, it is sometimes hard to figure out how we can have a functional society at all.

The Effects of Trauma

Trauma has all kinds of effects. Sometimes it is physical, such as the aftermath of an attack on a person, or an automobile accident. In some cases, it is both physical and psychological. In most cases, though trauma is psychological, and can vary from person to person. That is, the same set of events that one person may walk away from, as the result of personality, DNA makeup, or training, can be devastating to someone else.

First responders and soldiers, despite the prevalence of delayed-onset trauma in the form of Post Traumatic Stress Disorder (PTSD), may actually have a higher bar for what causes trauma in them than a civilian might have. Experts agree that the main driver of trauma is the subjective intellectual and emotional interpretation of an event by an individual, not the specifics of the event itself. That a person is not traumatized by certain occurrences does not make her or him unfeeling and callous. It makes her or him human, the same way that a traumatized person is human.

With that said, trauma is universal. There is not a culture on earth where trauma does not exist in the population – where individuals do not have the potential for the psychological aftermath of an event to crush their normal emotional responses to situations, and instead buffet the individual into a position of pathological fear of being annihilated, torn apart emotionally, dying, or losing their mind.

In many cases, those who are traumatized feel as if they cannot cope against the overwhelming weight of their own thoughts and emotions. Though physically absolutely fine, they may have the sense of being paralyzed. No matter how the trauma manifests, it is a terrible way to live. People respond to it in different ways, which are often described as self-medicating. Some get lost in self-destruction addictions to food, alcohol, or other substances or processes, others compartmentalize their lives in ways that do not allow them to grow, and still others develop debilitating anxiety, depression, dissociative, borderline personality, and other psychological disorders.

With so much prevalence of trauma, it is inevitable that conventional Western medicine has sought to address it. By any measure, the outcomes have been mixed, at best. Outside of the realm of psychology, medical doctors might offer the sufferer of various symptoms prescriptions that can, in the best circumstances, alleviate those symptoms, such as the benzodiazepine class of mood altering medication to lessen anxiety, or a selective serotonin reuptake inhibitor (SSRI) for persistent and chronic depression.

There are multiple difficulties with these medical responses, including their potential for addiction as with the benzodiazepine, and the uncertainty of response and difficulty in toleration for the SSRI anti-depressants. Moreover, there is a significant difference between the lethargy and unhappiness that is a psychological response to trauma, and the same symptoms that might be result of a serotonin shortage in the brain associated with severe depression.

Addressing Trauma

In the realm of psychology, talk therapists make a valiant effort to address trauma, and succeed in some cases. Among the paradigms used are cognitive-behavioral therapy to help patients address unhelpful thinking patterns, psychodynamic therapy to unpack deep-seated childhood memories that are mostly hidden, Eye Movement Desensitization and Reprocessing (EMDR) that combines talk therapy with a physical technique that focuses on the patient's eyes to unblock the effects of trauma, hypnosis, and other psychotherapies that are designed to help the patient manage the physiological effects that come from trauma activation.

These effects, like quick and shallow breathing, increased heart rate, and muscular tension, can form a feedback look with the brain and the endocrine system to move the patient to an unpleasant and at times overwhelming state of arousal. In addition to these protocols, psychotherapists have used therapeutic protocols like Acceptance and Commitment Therapy, and Dialectical Behavior Therapy to help the patient restructure their responses to the world and the people in it. Many therapists also advocate for mindfulness meditation, an increasingly popular modality that helps people to focus on the here-and-now in a world increasingly interrupted by notifications and marked by planning for the next thing or things.

It is hard to be opposed to any of these approaches, except for one inescapable reality: oftentimes, they don't work to alleviate a patient's suffering. Whether this is because the therapist does not recognize trauma as an underlying issue, the patient is resistant, or the trauma just too powerful in its impact is irrelevant, because the outcome for the patient is the same – ongoing misery. If the therapy did work consistently, it would be on the front page of the New York Times. There has to be another way.

Trauma & TCM

That another way is to re-approach trauma from the direction of Traditional Chinese Medicine (TCM). That approach treats both the psychological and physical effects of the underlying trauma by reestablishing the harmonic balance of the body, and giving it a chance to heal and re-regulate itself. According to the theory of TCM, energy travels on meridians through the body, and the adjustment of that energy flow through such modalities as acupuncture and herbal medicine offer a uniquely mind-body approach to trauma and its aftermath. In TCM, the body and mind are equally important – the flow of "qi," or life force energy through the body creates its own feedback loop. When the energy meridians are open, good things can happen. When they are blocked or stagnating, healing is far more difficult.

TCM practitioners will use a combination of acupuncture, relaxation training, meditation training, and the administration of certain herbs to help patients suffering from the effects of trauma. Some studies, like those by Strauss in 2011, have demonstrated that three months of twice-weekly acupuncture sessions compared favorably in terms of treatment gains to group therapy, and significantly better than those who received no treatment at all. Moreover, patient improvement lasted for the two years of the study. The combination of therapies was also superior to simple relaxation training alone.

One promising additional TCM modality is the Emotional Freedom Technique, which focuses on the body's qi by combining trauma processing and acupressure. In fact, there are some who conceive of Emotional Freedom Technique as psychotherapy through acupressure, where firm, fleeting physical pressure on acupressure meridians works quickly to alleviate energy blockages. When combined with talk therapy, the technique can often provide substantial relief for the patient that builds the confidence needed to address the underlying trauma.

Trauma is not simple to address, neither for the patient not the health practitioner. The most challenging of all are so-called complex childhood traumas, where the individual is subjected to repeated life disruptions during the first ten years or so of life, when she or he is particularly ill equipped to make sense of them. The trauma-sufferer will then use whatever works as a way of blocking the trauma's psychological daggers, no matter whether that method is ultimately self-destructive. The same is true for the traumas of adolescence and adulthood, with the somewhat greater possibility that the sufferer will be able to access memories when she or he is comfortable enough and confident enough to do that. The advantages of TCM treatment for trauma are that it is non-invasive, holistic, and can be done in concert with every other approach. For those whose lives feel disrupted, and when trauma may be the culprit, TCM offers real hope.

Resources

• Allen JG. "Coping with Trauma: A Guide to Self-Understanding." Washington, DC: American Psychiatric Press, 1995.
• Church D. The Effect of EFT (Emotional Freedom Techniques) on Psychological Symptoms in Addiction Treatment: A Pilot Study. J Sci Res Rep, 10 May 2013.
• Giller E. "What Is Psychological Trauma?" Sidran Institute, May 1999.
• Pearlman LA, Saakvitne KW. "Trauma and the Therapist." New York: Norton, 1995.
• Saakvitne KW, et al. "Risking Connection: A Training Curriculum for Working with Survivors of Childhood Abuse." New York: Sidran Press, Jan 2000.
• Sinclair-Lian N, Hollifield M, et al. Developing a traditional Chinese medicine diagnostic structure for post-traumatic stress disorder. J Altern Complement Med, Jan-Feb 2006;12(1):45-57.
• Strauss JL, Lang AJ. Complementary and Alternative Treatments for PTSD. National Center for PTSD: PTSD Research Quarterly, Feb 2012.