Editor's Note: This month's column is guest authored by Sherry Mizumoto, DAOM, MSTOM
Shen is the most subtle form of qi and can be translated in many ways. In my doctoral program, I was fortunate to have Giovanni Macciocia as one of my professors. He explained that shen may be translated as mind, spirit, consciousness, vitality, expression, soul, energy, God, psychic or numinous.
Shen indicates the activity of thinking, consciousness, self, insight, emotional life, memory, and volition. In relation to diagnosis, the word shen indicates a subtle quality of "life," "flourishing," "luster" or "glitter," which can be observed through the eyes, complexion, and tongue and pulse. The characters that make up the word shen may have some connection with an increased or extended "spiritual revelation." The combination of the two radicals of shen indicate that the shen of the heart is a subtle form of qi, something spiritual; an immaterial quality that "extends" toward others.1 I observed this revelation firsthand during the treatment process of the following patient.
According to the theories of East Asian medicine, the shen is housed within the heart and brain. If the shen is disturbed, both the mental and physical functions are compromised. In this case, deterioration of mental functions resulted in delirium, with the decline in physical functions resembling complications of stroke.
Shen Deficiency: A Facial Acupuncture Perspective
In regard to facial acupuncture, a person lacking shen coming brightly through their eyes and face is often described by TCM practitioners as dull or lackluster. Lack of shen can even be described as unattractive. In the event shen is damaged, both the mental and the physical aspects of the patient will be compromised. If the shen is disturbed by emotional stress, depression or anxiety, emotional instability can occur. In my clinical observation, disturbed shen will certainly affect qi. Since all emotional stress upsets the normal functioning of qi, in most cases it will affect qi first.
Confucius said, "Qi is the fullness (perfection) of Shen." The Su Wen states, "The Heart officially functions as the Monarch: the Spirit [Shen Ming] originates from it."
I enrolled in Dr. Shellie Goldstein's facial acupuncture course because I practice on Maui and it seemed a good fit for my patient population. My focus was on helping patients not only look better, but also feel better about the way they look. What happened during the course of my 20-treatment case study was not foreseeable to me and very exciting.
Case Study: A Patient With Severe Facial Trauma
I chose my patient due to her severe face trauma. Approximately eight months prior, the patient fell off a horse and hit her face and head on a tree. The injuries were extensive. Three surgeries over five weeks were performed. Her right was eye placed back in the socket; broken right zygomatic, left nasal bone and left side of mandible, closed brain injury (bruised and torn brain tissue), frontal lobe dysfunction.
Her symptoms were slurred speech, anxiety, depression, pain, post-traumatic stress disorder, migraines, and inability to complete executive tasks. The patient stated feeling disassociated with her body, fearful, forgetful, foggy thinking, loss of time, bilateral eye floaters, bilateral arm px and numbness. I chose to treat her twice a week for 10 weeks.
P: Fine, weak; T: Dry, patchy, slightly swollen, red edges and tip, horizontal cracks, no coat.
TXP: Calm shen, clear phlegm, course liver qi, move blood, and tonify kidney, blood and liver yin.
TX: Facial points included Du 24, bilateral Shenmen, KI 3, SP 6, LI 4, GB 1, 14, Surround the Dragon over right eye scar, and ST 4, 6 and 7. Supplementary points included LV 3, LI 4, PC 6 with LED therapy; 25 x 30 filiform needles obliquely inserted and retained for 30 minutes. (LED treatments were completed twice a week for five weeks totaling 10 treatments.)
Outcome Over 10 weeks
The outcome of each treatment was rapid improvement. I could see the change, especially in her shen, that was very evident. I had friends of hers telling me they noticed she was "back in her body" and that she "seemed like herself again." The patient herself told me she began feeling more confident overall and began completing executive tasks, like keeping a calendar, the first week. Each week, she expressed her improvements and how people she worked with were noticing the change in her "spirit." She reported weekly improvements as follows:
Week 1: "During the first session I began feeling prettier, more integrated with my body, and almost immediately began to sleep better."
Week 2: "The lightning-bolt scar around my eye has begun to soften; the pain, swelling and discoloration is decreasing while my vision has begun to improve."
Week 3: "My sleep-wake pattern is much healthier and balanced. I still nap and am not 100 percent yet with my endurance, but I am definitely improving."
Week 4: "My smile has begun to look like mine again."
Week 5: "I am noticing my executive functioning returning, such as keeping a calendar, and memory greatly improving."
Week 6: "People are telling me my skin is looking great! I look refreshed, healthier and younger."
Week 7: "During my appointment with the plastic surgeon, he was blown away by my improvement within the three months he hadn't seen me. He said, "Whatever you are doing, keep doing it!"
Week 8: "Although I now wear 2.5 prescription glasses, I can see details miles away and my migraine headaches are far less frequent than they were prior to beginning treatment with Dr. Sherry."
Week 9: "My smile and speech are back. (I slurred my S's and T's, and my smile was crooked.)"
Week 10: "I do not feel shame any longer. I feel pretty and much more confident. These sessions have changed my life. The progression of my improvements was much faster than I could have hoped for. Mahalo Nui Loa, Dr. Sherry!"
A Spiritual Revelation?
A "spiritual revelation" is what I believe we were all seeing in this patient. I observed her shen extend and reach out of her body, with renewed vitality for the first time since the trauma. The patient's mind, body and shen reunited and fully integrated once again.
It can be stated that the beauty of a person really isn't how many lines they have in their face or what is considered good facial structure, but the integrity of their shen. I believe beauty to be far more encompassing than needling the lines of the face and working on symmetry. To me, it is our expression of the shen that tells others how beautiful we are.
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.
