Not Guilty!

In Traditional Chinese Medicine disturbances in our emotional life are considered to be a major cause of illness. If healthy emotions are ones which are appropriate to the situation we are in, an unhealthy response is one that is not so appropriate, either excessive, inadequate, or just not fitting. Such responses if they are ongoing or habitual lead to illness.

So, for example, there are situations where it is healthy and appropriate to be angry, but if our anger is out of all proportion to the situation, or we are always angry and always on the edge of losing our temper, then not only will this be distressing to those around us, and to ourself, but also it will over time make us ill.

Traditionally, emotions which can cause problems by becoming excessive or ingrained are anger, sadness and grief, fear, excitement and pensiveness. But what about something like guilt? Guilt plays a significant role in the lives of many people, but is not mentioned in traditional lists.

What, anyway, is guilt, and how might it be a factor in our health? We might suspect that in the modern world there is some confusion about this, as ideas about what is right and wrong have changed considerably in a relatively short space of time. Guilt is a feeling we have when we have done something wrong, or rather when we have done something that we consider to be wrong. Of course, this may equally apply to something that we have not done but feel we ought to have done. Perhaps we feel remorseful, that we have let ourselves and others down. But on the other hand, it is noticeable that quite a few people seem to feel guilty when they do not seem to have done anything to be guilty about.

Some people, for instance, feel guilty if they have a rest. They feel that they ought to be doing something, almost as if they can only justify their very existence by being useful. They may drive themselves into the ground, always working and busy and useful, to the detriment of their overall health, simply because they would feel guilty if they stopped. Of course this can be a convenient failing for others – family members, co-workers or bosses – who may come to rely on the guilty person’s addiction to work and usefulness.

It is important for such a person to realise that they are being driven by this irrational guilt; it is important to acknowledge that it is not healthy, not a good thing. This might be difficult, because  it may look, both to the individual themselves and to others (especially ones with a vested interest), as if they are making a valuable contribution by being so busy.

Such a person may in fact need to learn to waste time, as shocking as that may sound! They need to learn that they do not need to justify themselves by being busy, and they may also need to learn to say ‘no’, sometimes, to family members, co-workers and bosses.

Acupuncture treatment is a good first step for such a person, if for no other reason than it involves them spending an hour or so of their time not being busy (and 20 minutes or more of that time lying down to boot!). But beyond that,  acupuncture can work at a deeper level of the psyche, helping  them  perhaps to  realise that they do not have to justify themselves by work and busy-ness, and that they need not feel guilty if, from time to time, they have periods of uselessness!

A Bad Day at the Office?

Most of us spend a large part of our life at work, so what happens at work has a major influence, for better or for worse, on our health and happiness. It’s almost customary to regard work as a necessary evil that we have to put up with to pay the bills and, if we are lucky, to buy the things we want and the holidays we can look forward to. But is that enough? Can we make our work a satisfying and fulfilling experience, not something to simply endure?

Work is one of the main places of course where we come into contact with other people, and not necessarily with the kind of people we would ordinarily choose to be in contact with! This might be direct contact, if we are for instance a shop assistant, a nurse or a flight attendant, or it might be indirect, if we are a software designer, a writer or a fighter pilot. So quite often what makes the difference between an enjoyable day at work and a day that drags on interminably and leaves us drained and consoled only by the thought of the coming holiday, is other people.

Or is it? Is it not rather how we communicate with those other people, how we think about them, how we respond to them?  Other people, after all, can be miserable, depressed, irritable, unco-operative, bored, irrational, irresponsible, unreliable, contrary, lazy and inefficient. It is a jungle out there. If our happiness and well-being is to depend on the other people our work brings us into contact with, we are a hostage to fortune and no mistake! No wonder if we sometimes end up drained and fed up after a day at the office.

Other people, by and large, are out of our control. If someone won’t do what we want them to do, there is, in the final analysis, nothing we can do about it. Of course we can ask them tactfully, skilfully, kindly, we can bring to bear the full weight of the greatest communication techniques anyone ever possessed, but they still might not do what we want. Or, we can maybe try to force their hand, but that might not work either.  They may remain frustratingly outside of our control.

But what we do have control over – or rather, what we can learn to influence – is how we respond to this latest saboteur of our will. Herein lies, perhaps, the secret of a happy life, and in particular a happy work life.

What usually happens  in such a situation, is that we either get angry, or resentful, or despondent. It might be a small thing, a momentary response, something we will have forgotten all about in a few hours. But the day is often made up of such small things, and such fleeting emotions. It all adds up.

What might happen, then, if we were to gradually train ourselves to respond to people in a new, different way? If, in a way, we were to learn to take things less personally? A long time ago now, I worked as a door to door fundraiser for a third world charity. A small team of us would go out on to the streets of London in the evening, knocking on doors and looking for people to support, by a regular standing order, our work with some of the very poorest people in India. Of course we learned to recognise the signs of a house having someone in it who might be sympathetic to such a request (if you could see shelves of books, and even better, a piano, you might be on to something), but even so, occasionally we would encounter some irate individual who would start to visit a tirade upon us about charity beginning at home, the corruption of the Indian government, how people should learn to stand on their own two feet, and so on. I remember a little slogan our trainers used about such a situation, advising us to reflect that it was just “their conditioning slagging off their projection.” In other words, this sorry person’s anger was all about them and not much about us, so we should move on and leave them to it. It’s easy to get down-hearted, or maybe even angry, in such a situation, and perhaps more so from the rather more frequent polite ‘no thankyous’ we inevitably encountered. But in this situation you had to remember that all you could do was to attend to your side of the communication, and leave the person to respond as they want. I suppose it’s a bit like fishing; you can cast your bait, but you can’t make the fish bite.  (Actually what we found was that there were an encouraging number of people out there who did in fact want to do something about the suffering in the world, and who were  actually grateful to be presented with an opportunity to do so.)

So in our interactions with other people, maybe if we can just focus on our side of the fence, doing our best to communicate as effectively as possible, always realising we are dealing with a fully automatous ‘other’ who has a will of their own which cannot, ultimately, be forced to comply with ours, maybe we can save ourselves (and them) a bit of grief.

Probably to begin with we can only expect to make small changes. Maybe when that colleague fails, yet again, to do what they said they would do, we can respond not with resentment but with, say, curiosity (why are they so unreliable? We might even think about asking them!). But such apparently small changes in our response can make a big difference to our day. Emotions like anger, despair and resentment are , ultimately, rather draining. It is really these that can leave us, at the end of the working day, fed up and exhausted. It’s not other people, not the job.

In the Buddhist tradition this really rather radical way of approaching life finds its culmination in a person known as a Bodhisattva (an’ Enlightenment being’). Such a person lives only to ease the suffering and pain in the world, and his or her days are devoted to that end. You can imagine that that might be frustrating or dispiriting, but the Bodhisattva has trained themselves to respond not with anger, or despair, or even pity. Consequently, they are known for their energy. Indeed their activity to them is ‘lila’, which means ‘play’. They have the spontaneity of a playful child.

It’s not easy to be like that, but as the Chinese say, a journey of a thousand miles begins with a single step. That step involves us recognising that it is not other people who wear us out, get us down, frustrate us and make our job, sometimes, a misery. It is ourselves.

Don’t Be One Of The Worried Well

The worried well are, apparently, on the rise. In some ways this is not surprising given the frequency of headlines highlighting the way in which all sort of things can be bad for you. As I began writing this I had a quick look at the Daily Mail online health section, and had no trouble finding out that white wine drives some women crazy (not in a good way), and that rice cakes and red meat are bad for your skin. So if you do have a tendency to worry about your health, you can find plenty of things to worry about.

However, it is important to take such headlines with a pinch of salt (or it would be, except too much salt can raise your blood pressure.) A useful antidote might be the work of John P.A. Ioannidis, a professor of health research and policy at Stanford School of Medicine in the USA, who in 2005 published a paper refreshingly, entitled ‘Why Most Published Research Findings Are False’. The moral of which is, one bit of research does not prove anything; it needs to be backed up by subsequent studies (and often it isn’t.) Given also that journalists will almost inevitably simplify any research they come across in the interests of catchy headlines, so that a research paper which concludes that, say, eating too many pickled onions may be associated with an increased risk of dementia may lead to a headline ‘onions cause dementia’, we would do well to remain healthily sceptical. (Don’t worry onion eaters, I made this one up.)

But if we can’t rely on such headlines, or, if Professor Ioannidis is right, on most published research findings, what can we rely on? Can we rely on how we feel? What about the silent killer, high blood pressure? The received wisdom is that your blood pressure may be high, and you may not know it. Similarly, you may feel fine, but your cholesterol might be up. You might even be pre-diabetic. Any number of things may be going wrong inside you, and you don’t know it! Personally I’m slightly sceptical about that; I think it depends on how self-aware you are. I think someone who is deeply in tune with themselves, someone who cultivates awareness, would have a sense that something was not quite right.

Health, anyway, is more than the absence of disease. It is more than a few numbers – blood pressure, cholesterol, body-mass index etc – being in the normal range. In Traditional Chinese Medicine (TCM) we say that a healthy person is one with abundant Qi which is flowing freely, and whose spirit is bright (something you can see in their eyes). Such a person does not, for instance, catch colds very often, and when they do they recover quickly. They have a good level of energy for their time of life. They sleep well. They are supple and lithe. Also, they have a good understanding of their constitution and know how to get the best of the cards they were dealt at birth. They feel healthy. They look healthy.

Furthermore, healthy people do not worry – the term ‘worried well’ is really a contradiction in terms. Health includes emotions, and in TCM our emotional health is a major component of our overall health. And worrying is unhealthy. Well, its not unhealthy to worry if a hungry looking tiger has her eye on you, or if your car has broken down on the level crossing. But it is unhealthy to worry habitually, including worrying habitually about your health. Several ancient wisdom traditions, both eastern and western, recommend the following antidote to worry: if there is something you can do about the problem you are worrying about, then you need to stop worrying and get on and do whatever it is you can do (or at least make a firm decision that you are going to do it). If on the other hand there is nothing you can do about the problem, then worrying is not going to make any difference, so you may as well not worry.

Can you apply that to worrying about your health? I think you can. There are certainly things that you can do to improve and maintain your health, although the difficulty is that there are an almost infinite number of them. So maybe you need to make a finite list of things you are going to do. It might, for a hypothetical individual, look something like this:

• Go for a run three times a week
• Don’t buy chocolate bars
• Have a regular acupuncture treatment
• Go for a walk in the countryside once a fortnight
• Have breakfast every day
• Have an ‘MOT’ with the GP once a year
• Don’t get drunk more than once a month
• Eat home cooked meals five days a week
• Go to a Tai Chi class every week

The trouble is that the fact there are more things you could do may give an opportunity to your internal worrier to take over – “maybe I should go for a run five times a week, not just three?” Or, “maybe running is bad for my knees and I should give it up?” “Maybe homeopathy is better than acupuncture?” “Maybe I should give up pickled onions?” I think you should ignore such a voice. Establish a lifestyle that you think is viable and will promote your health; it won’t be perfect, but nothing much ever is. It doesn’t need to be perfect. It just needs to be reasonably healthy and realistic. Then kick worry into touch.

That all might be easier said than done. Most of us need help in maintaining our health, and some of us need help in dealing with a tendency to worry, whether about our health or anything else. At The Sean Barkes Clinic we are well placed not only to use treatments such as acupuncture and Tuina massage to promote your health, but also to use the time honoured understanding of health which is TCM to help you lead a healthy life – to help you become one of the unworried well!

When Does Dedication Become Obsession?

In Traditional Chinese Medicine, health is seen very much in terms of harmony and balance. So it should be clear that obsession, which is virtually by definition a state of imbalance, is an unhealthy place to be. Obsessional behaviour is of course quite common; the term ‘OCD’ has entered the language, and many people will describe themselves as having some obsessional traits, ranging from mild idiosyncrasies to full blown mental health problems.

But is obsession always bad? Is balance always such a good thing? Suppose you want to achieve, and not in a mediocre kind of way; perhaps you want to be an elite athlete, even an Olympic champion. Perhaps you want to be a millionaire. Maybe you want to find the cure for cancer. It’s clear that you will need to be one-pointed. Dedicated. Even, maybe, obsessed?  There might be a fine line between a healthy dedication and an unhealthy obsession, and it is not clear where that line should lie. Could one man’s dedication be another’s obsession? If you want to achieve big things, you will have to make sacrifices, but how far should you go?

For example, think of Lance Armstrong, who seemed the very image of the dedicated champion, even overcoming what looked like a fatal cancer, until it turned out that his thirst for success and glory had led him to deceive everyone. Had his dedication gone too far? Had he become obsessed with winning at all costs? If we are aiming high, how do we avoid such a mistake?

If we do find ourselves becoming a little obsessive about our goals, one question we need to ask is, are our goals big enough, are they worth dedicating ourselves to? Perhaps dedication becomes obsession when the goal we aim for is not worth the sacrifices we make along the way. If you were to dedicate your life to collecting Mars bar wrappers, for instance, giving up all your spare time to hunt through rubbish bins, this would be an obsession.

But what actually is worth dedicating ourselves to? I’ve just come out of a supermarket which seems to like to project an image of its workforce as living only to provide happy smiling excellent customer service (although the reality seems more often that the staff devote themselves to ignoring the fact that they are blocking your access to the groceries you want!) I imagine when they advertise vacancies they say they are looking for people with a passion for customer service. Does anyone really have such a passion? You could dedicate yourself to being such an employee, but when it came time to retire, or even be made redundant, what would you have to show for it all?

Perhaps more ambitiously you might devote yourself to a career, maybe in big business. You may need to demonstrate a commitment to succeed bordering on obsession, which your bosses and peers might be glad to describe as dedication. You might have to make a lot of sacrifices along the way – your relationships might suffer, as might your health. But it will be all worthwhile when you finally make it, won’t it? Or will it?

In the past people would often devote themselves to religion, perhaps becoming a monk or a nun and thus sacrificing family life, sex, possessions, even individual autonomy. Nowadays their fervour might seem more like fanatical obsession, reminiscent of the kind of thing that leads turns people into suicide bombers. In today’s world it sometimes seems that sport has taken the place of religion for many people. Some people dedicate themselves to being a fan. They might spend all their spare cash supporting a soccer team, buying replica shirts, following their team everywhere, being absolutely distraught if they lose and ecstatic if they win.  Some fans even have had their ashes scattered on the pitch of their favourite club after their demise. Is this dedication or obsession?

And what about the sporting men and women themselves? If they want to be the best, they will certainly need a prodigious degree of dedication, but as the case of Lance Armstrong illustrates, this can turn into something less than healthy. This also appears to be the case with Oscar Pistorius, someone who overcame tremendous difficulties in his pursuit of athletic excellence, but if some of the stories circulating around his trial are to be believed, turning him into a bad tempered obsessive.

Even setting aside such fallen heroes, we might (rather heretically?) ask what is so good about a gold medal, or winning the premier league? How much are such things worth, really? How much is it worth sacrificing for them? How much dedication/obsession is justified in their pursuit? If you are a top-level sportsman or sportswoman you are probably surrounded by people, maybe including thousands of adoring fans, who would not even dream of asking such a question.  But as the ancient Greek philosopher Socrates is said to have pointed out, the unexamined life is not worth living.

Perhaps one aspect of the answer to these questions is indeed related to our health – in the broadest sense. We can ask ourselves if in the pursuit of our goals we are becoming healthier and, even, happier and more fulfilled. In Traditional Chinese Medicine we have the idea of a person’s destiny; this is not fate, but more like an innate potential. In a way our destiny is who we really are, so that as we gradually fulfil our destiny, we become more and more ourselves. This is a deeply satisfying experience, a humanising experience.

But what is our destiny? As with most things in life, we find out as we go along (or not!) I knew someone who in his youth wanted to be a fighter pilot, but who realised as he got older that  what he really wanted was freedom – which for him was symbolised by a fast jet racing across the sky. So as we move through life we need to be open to our goals changing, or rather be open to finding out that what we thought we wanted is not what we really want. If my friend has clung doggedly to his ambition to be a fighter pilot, maybe he would have become one, but maybe also he would have been secretly disappointed and grumpy. (But then again, for someone else, zooming across the heavens at twice the speed of sound might be part of the journey they need to make.)

From this point of view, dedicating ourselves to a goal which is (at least for the time being) congruent with our destiny will indeed lead us to a more fulfilling life. If on the other hand we find ourselves becoming grumpy, angry, miserable, difficult to live with and ill, it may be that we have become fixated on achieving something which it is not really in our interest to achieve. In such a case we need to take a deep breath and see if we can let go of that goal and follow the advice of the Sufi poet Rumi:

“Let yourself be silently drawn by the stronger pull of what you really love.”

This brings us back to the idea of balance. Balance is not mediocrity; it is not a static thing. We don’t achieve it by sitting on our hands and doing nothing.  If our goals are such that striving for them indeed helps us to gradually realise our destiny, then as we struggle towards them we become more balanced, not less. We draw on energy we did not know we had, which would never have been called forth if we had not aimed high. Of course this is not plain sailing and we will indeed have days when we feel anything but harmonious, but the overall trajectory of our life is in the direction of fulfilment and equilibrium. Far from being obsessed with something which is really of little significance (like winning the premier league or becoming a millionaire!), we dedicate ourselves to something worthy of us and our destiny.

Of course we cannot do all this in splendid isolation; we need help and support. At The Sean Barkes Clinic, this is what we do; using the tools of Traditional Chinese Medicine, we help people achieve the dynamic balance that comes with fulfilling their destiny by optimising our patients’ state of health. For further details, follow this link

Demystifying Chinese Medicine: Why Is It So Good At Treating Back Pain?

Although acupuncture and Traditional Chinese Medicine (TCM) is used in the treatment of a very wide range of health problems, in the West many people associate it especially with the treatment of back pain. NICE (the National Institute of Health and Care Excellence, the organisation responsible for providing the guidelines to the NHS on treatment options for different conditions) lists  a course of acupuncture  as one of the recommended ways of treating persistent, non-specific low back pain. Many people have positive experiences of acupuncture relieving their back pain. So why is TCM acupuncture so good at treating back pain?

The simple answer is experience; acupuncture has been used for literally thousands of years in the treatment of back pain, which was, one can assume, almost as much a problem for first century Chinese as it is for twenty-first century Europeans. Over the centuries then, there has developed a sophisticated and effective way of both diagnosing different types of back pain, and of treating that pain in accordance with the diagnosis – the combination of accurate diagnosis and effective treatment is, of course, the key to any successful treatment.  Traditional acupuncturists today are the heirs to that body of knowledge; and since acupuncture is used a lot in the treatment of back pain, individual acupuncturists also quickly build up their own personal expertise to augment this inheritance.

Of course back pain has also been treated in the West, one way and another, for hundreds of years; perhaps, however, practical knowledge has been lost or discarded due to the twentieth century enthusiasm for tablets as the cure for everything; in particular a hands-on approach to back pain is no longer in favour. (A clinic I once worked in had a telling cartoon on the noticeboard; an old man sits facing a doctor, who is telling him that he has to expect a few aches and pains at his age, and handing him a prescription for some painkillers. The old man then gets up to go, revealing an arrow protruding from his lower back!) Sometimes indeed one finds remnants of  lost skills outside of both conventional and alternative medicine,  in the most unlikely of places; some of my patients had very positive experiences of being treated by a lorry driver who had, apparently,  considerable intuitive and practical skill in relieving muscular-skeletal pain.

A hands-on exam is a crucial part of the diagnostic process in TCM. This reveals quite a lot of useful information to the skilled clinician, who will notice, amongst other things, points and areas of tenderness, the tone of the musculature, variation in temperature, and so on. (Incidentally, it is often a relief to a patient simply to have their back examined in this kind of way: sometimes it seems that it is only when this happens that they feel their problem is being taken seriously, that their experience is validated.)

However, as well as a thorough exam of your back, the TCM clinician will also be interested in other aspects of your health which (you might think) have not much to do with what has gone wrong in your back. This is part of a holistic approach to back pain which integrates the information gained from the exam together with information gleaned from the patient about how they actually experience the pain, what makes it worse and so on, with an overall picture of the patient’s health. Sometimes, indeed, the back pain is simply the most marked symptom of an underlying disharmony.

The acupuncturist thus arrives at a diagnosis which helps him or her understand what is wrong with your back, and what relation this may have to underlying or systemic disharmonies which may either have caused the back problem or be inhibiting the body’s healing response.

It’s important to understand that this diagnosis is distinct from a western medical diagnosis. A TCM clinician will not tell you that you have a disc prolapse or spondylitis; rather they may say you have a Cold-Damp obstruction of the Tai Yang meridian of the back, Liver Qi Stagnation, or Kidney deficiency! This is confusing to most people who naturally assume that the kind of diagnosis made by a GP or other western health professional is the only real kind of diagnosis there is. To understand this, it may be helpful to use the analogy of a map. You might be used to using one kind of map (a road map perhaps), but this does not mean that any other kind of map (an ordnance survey map, say) is wrong; it simply maps the area in question in a different kind of way. Similarly there are different ways of ‘mapping’ a human being, which can be useful in different situations. So a TCM acupuncturist makes a diagnosis using the TCM map, not the western medical map.

(Of course if you are told, say, you have Cold-Damp obstructing your meridians, you may well feel none the wiser, although in fact you will probably also be none the wiser if your GP tells you that  you have spondylitis. In fact, even if they tell you it is arthritis, you will probably only have a very vague idea of what arthritis is!  But in brief, back pain means that the flow of Qi in some of the meridians which flow through your back are blocked; in Chinese medicine, this is what pain essentially is, an impairment of the free flow of Qi. Sometimes this blockage is due to cold and damp as it were getting into your back, in much the same way they might get into an old house. This is of course more likely to happen if you live in a cold, wet climate, and if you do not take care to wrap up properly, but it may also be due to poor dietary choices or other such factors.)

Once established, this diagnosis  leads to a clear set of treatment principles, aimed at both alleviating the back pain directly and restoring health and wellbeing holistically – which in turn further helps alleviate the pain, promotes healing,  and starts to resolve the underlying imbalance behind the pain.

Whilst acupuncture is often the treatment of choice in this treatment programme, the TCM  clinician has more than one arrow in his or her  quiver, tried and tested treatment modalities which he or she may use in addition to acupuncture, depending on the diagnosis. These include Tuina massage, cupping, moxibustion, herbal ointments, gua-sha and electro acupuncture (a more recent addition to the therapeutic armoury). Furthermore, the diagnosis also may lead to the clinician making specific informed suggestions about things we can do ourselves to speed up the healing process.

This makes it clear that there is a lot more to the treatment of back pain than simply sticking a few needles in the general vicinity of the pain. The reason why TCM is so effective for back pain is that it builds up a sophisticated and accurate diagnosis and then tailors its treatment in the light of that diagnosis.

Athlete’s Are Not All Just Wheels and Chassis: Mastering the Ability to Heal

Injury is part of an athlete’s life; it can be a minor inconvenience, an ongoing niggle or, sometimes, a devastating blow. Injuries can be frustrating, a test of patience; athletes often do not cope very well with a period of enforced inactivity. An injury which prevents you from participating in your chosen sport for several months can even lead to depression.

So, how you respond to injury, especially serious or long term injury, is, or should be, part of what it means to be an athlete – whether professional, amateur or weekend. Consider for a moment how you might respond if someone you are close to starts to complain about your relationship with them. If you are wise you will listen to what they have to say and consider it carefully, even if your first instinct is that they are wrong. You may not agree with what they are saying, but you can’t afford to ignore them – something is up. Ignoring them, or “papering over the cracks”, is the worst thing you can do.

It’s the same thing with your relationship with your body – it is not a coincidence that the word ‘complaint’ can mean either a spoken objection or a medical problem. If you sustain an injury, it means your body is complaining and, especially if the injury is long term or recurrent, or if it is the latest in a series of apparently unrelated injuries (commonly but erroneously considered to be ‘bad luck’) you need to stop and listen. As an athlete, in fact, you need to learn to be sensitive to your body and what it is telling you, not just when you have an injury, but before you get that injury. We must learn how to know and trust our body’s healing process.

We  can take this healing process for granted, but if you stop to think about it, we have a really rather incredible ability to repair ourselves. It might be instructive to compare yourself with your car, if you have one. (An interesting question to ask may be how much do you spend on keeping your car working, versus how much you spend on keeping yourself working.)  If your car is damaged, you can’t just leave it in the garage for a few days and expect it to be mended. Sometimes it might need a bit of help from a clinician, but your body can often heal itself pretty well; if it couldn’t, our species would not have survived, medicine of any kind being a rather late human invention. What a good clinician does is to support the natural healing process where it needs it. The father of the poet W. H Auden, a doctor and professor of public health, put it well: “healing… is the intuitive art of wooing nature.”

From this point of view, the easy availability of some painkillers is a mixed blessing. There is a growing body of evidence to suggest that Non-Steroidal Anti-inflammatory drugs such as ibuprofen actually slow down the healing process. Inflammation is painful, but it is also part of nature’s way of starting that process. (Of course the pain also serves nature’s purpose – it tells us we may need to stop doing what we are doing and recover, and tells us a lot about what the problem is and where it is.) This is not to say that you need to avoid all painkillers or other forms of analgesia (especially the ones without so many side effects!), but that getting into the habit of unthinkingly blocking out pain is like getting into the habit of not listening to your friends when they say things you don’t want to hear.

Another way in which we are different from cars is that we are so much more complex; we are an organism, not a machine. Our body is a miraculous network of inter-relationships, and our idea of how it works is usually hopelessly simplistic. So if we have a recurrent or chronic injury in a particular area, say the Achilles tendon, we need to realise that our Achilles is not something which exists in isolation from the rest of us. The healing process, for instance, relies on the appropriate nutrients being transported effectively around the body so that damaged tissues at the extremities can start to heal. If our circulatory system is not tip-top (one clue might be a propensity to cold feet and/or cold hands) then our tendon injury will not heal as fast as it would otherwise. Obviously, you can make the same kind of case for other organ systems; a weakness in one area has effects on everything. Our digestive system needs to be good at absorbing nutrients; our kidneys need to be good at expelling waste products; our lungs need to be good at getting oxygen in, and so on. In fact a problem with any of the organ systems will inevitably have an impact on our injury – whether we get it in the first place, how quickly it heals, whether it recurs. Recurring or chronic injury is probably telling us that there is a weakness somewhere, and not just in the site of the injury.

Another difference between you and your car is that you have a mind, a soul, consciousness, or whatever you want to call it. Responding to injury is not just a matter for purely physical processes in your body. In fact one might doubt whether there are such things as purely physical processes in human beings, in that emotional and cognitive aspects of our being have such significant impacts on healing. If you doubt this, you only have to consider the placebo effect. Fifty years ago many medical professionals might have doubted that such a thing existed, but nowadays it is such a recognised medical fact that all new treatments are compared against placebos to measure how effective they are. In fact, the idea that mind and body are separate entities is an idea which is a few hundred years out of date. Mind effects body, body effects mind. Mind and body are perhaps better thought of as two aspects of the same reality, with a very blurred boundary between the two.

What this means for an athlete is, of course, that mental factors affect not only athletic performance, but recovery from injury. As already mentioned, long term injuries can be mentally challenging, so that in the treatment and management of such injuries we need to include ways of supporting ourselves mentally and emotionally.

What this all means is that as athletes we need an holistic approach to our body and its injuries, not a mechanistic one. We need to develop our understanding of and sensitivity to our body, heed the messages it gives us, and promote health, healing and performance in a way which does not seek to over-ride nature, but work with it.

Proper acupuncture draws upon a substantial and sophisticated understanding of human health, developed over millennia, called Traditional Chinese Medicine. An acupuncturist who uses the technique within this traditional context, (rather than as an adjunctive technique tacked on to modern medicine after a couple of weekends training – check this link for more on this distinction), can help an athlete’s body-mind regain the balance that once existed before the injury began. They can therefore help facilitate improved athletic performance both physically and mentally.

In contrast to more modern mechanical approaches, the outcome of the treatment process is thus not just the absence of injury but also more energy, improved mental state, better sleep and, ultimately, improved performance. These are the outcomes we love to watch with our athlete patients at The Sean Barkes Clinic.

Mind, Body and What?

Sometimes when we want to make it clear that we are referring to a human being in their totality, we might use phrases like ‘body and soul’ or ‘mind, body and spirit’. But what do these words mean? We may think we know what a body is, and we may even think we know what a mind is (although we might find ourselves having a bit of difficulty if pushed to define it), but what about words like ‘soul’ and ‘spirit’? Surely these are candidates for the vaguest words in the English language, and indeed one might suspect that they are sometimes used by people who have a vested interest in keeping things nicely vague.

In fact the English words ‘soul’ and ‘spirit’ both have their origins in ancient words meaning ‘breath’, reflecting the observation  that someone who is breathing is alive, whilst someone who is not breathing is dead. A dead person may look the same as they did when alive, except that they are no longer breathing, so one can understand how people would have correlated the breath with the apparently departed essence of the deceased, their soul or spirit. Belief in an afterlife of some form or other often rests on the belief that there is something essential within us that animates our body during life and then leaves at death. The rise of materialistic philosophy means that, perhaps, fewer people believe in life after death or in the existence of an immaterial essence within us. ‘Soul’ and ‘spirit’ are not part of the (official) vocabulary of western science or medicine.

So perhaps these days it would be better to just talk of ‘mind and body’. But on the other hand, maybe there are important, even crucial, aspects of human beings which the phrase ‘mind and body’ does not grasp. To begin with, one of the common ways the word ‘spirit’ is used, as for example in the phrase ‘fighting spirit’, is to denote something like enthusiasm, vigour, liveliness; we may say of someone that they are a spirited individual, or that they are high spirited. In this sense spirit seems to be used to indicate how alive someone is. A healthy person is one whose body functions smoothly, who is of sound mind, but also one who is quite simply very alive. In Traditional Chinese Medicine, a clinician will assess the health of a patient’s spirit by, among other things, noticing their eyes (‘the windows of the soul’ as the English phrase has it); someone with a healthy spirit has sparkling, lively eyes, whereas someone whose spirit is impaired may have dull, lifeless eyes.

Similarly, the word ‘soul’ may still have some value. Think of how it is used to talk about music, and how we might say of someone that they are ‘soulless’. A work of art may be the product of great technique, but if it has ‘no soul’, it will not touch us; a person may say all the right things, but if he or she seems soulless, we will not trust them.

The reality is that the human being is a complex and marvellous thing, and the phrase ‘mind and body’ just does not do enough to capture him or her. In particular if we are considering things like health and well-being, it is crucial that we do not focus solely on the body or even solely on the body and mind (especially if we want to think of the mind as simply a bunch of physical processes in the brain.) We may also need to ask, how is our spirit? What is the condition of our soul?

Spirit and soul in this understanding are not ‘things’. Experiments such as the one conducted at the start of the twentieth century to try to weigh the soul by weighing a person just before and just after death (when the soul, presumably, will have flown) are of course wholly misguided. Spirit and soul are not things to be measured. There is not a spirit inside us in the way there is a pituitary gland inside us. These are words which are not to be taken too literally.

In fact, it is best not to take even the phrase ‘mind and body’ too literally, if by that we mean the mind is one kind of thing and the body another. Where does mind end and body begin? Since the influential French philosopher Rene Descartes in the seventeenth century, westerners have tended to think of the body as a physical thing, a machine, inside of which is something else – mind, soul or spirit – the ‘ghost in the machine’. Modern science may have eroded this dualistic way of thinking at least to an extent, but it might be instructive to look at how Traditional Chinese Medicine views the individual, for it has no place for such dualism. Here a person is composed of ‘three treasures’ – Jing, Qi and Shen. Shen, often translated as ‘spirit’ or ‘mind’, is nevertheless not wholly immaterial but simply a more refined form of Qi, just as Jing or ‘essence’ is a more condensed form of Qi. In other words the three treasures are all Qi, which is neither wholly material nor wholly immaterial.

So instead of ‘body, mind and spirit’ we could talk of Jing, Qi and Shen, which in some ways is less misleading, since it does not depend on what turns out to be a false distinction between the material and the immaterial. But the main thing is that, whatever expression we use, we do not take it too literally, and we do not use it to exclude, ignore or forget about any aspect of that marvellous and complex phenomenon, the human being.

Treating Psoriasis with Acupuncture

Ancient Chinese Medical Knowledge in the Modern World

The Chinese have been using acupuncture to treat psoriasis for thousands of years—descriptions of the disease are found in the earliest Chinese medical texts. At the Sean Barkes Clinic we follow in this tradition.

Treatment begins with a careful examination of the affected parts of the body and a detailed consultation in which we discuss not only how you experience the psoriasis (Does it itch? Does it feel hot? Does it get worse if you are stressed?….) but other aspects of your health as well. This is because our treatment is holistic and we consider that what is happening on the surface of the body in some way reflects various imbalances deeper within. You could say that we don’t so much treat the psoriasis as the person who is suffering from the psoriasis.

From this perspective, psoriasis is just the manifestation of an underlying imbalance and we use our understanding of the principles of Traditional Chinese Medicine (TCM) to figure out what this imbalance is. So when you first come for treatment we do a detailed consultation in which we ask quite a few questions about your health, everything from how you sleep to the state of your bowels, from headaches to perspiration; we are looking for clues about what is going on inside. We take your pulse and look at your tongue (if you don’t mind sticking it out at us!). All this helps us understand, in terms of Chinese medical theory, what is giving rise to the psoriasis.

Once we have this understanding, which we will share with you, we can use acupuncture to start to resolve this underlying disharmony. This involves inserting a few very fine needles into key points on the body, called acupuncture points. We choose points which enable us to regulate your Qi (a Chinese word used to collective function and vitality of an organism. Literally, ‘life-force’ or ‘vital energy’) and move you in the direction of balance and full health. The needles are so fine that you probably won’t even feel them go in; its certainly not like having an injection! Most people find treatment itself deeply relaxing.

Our treatment is thus individualised to each patient – no two people with psoriasis are the same, and we think it is important that treatment reflects this. We can also, therefore, discuss with you other things you may be able to do that will help restore your health.

The holistic approach means that we look not only to reduce or even eliminate the psoriasis, but to help you to even better health overall.

Our treatment of psoriatic arthritis follows the same principles; again we see the joint pain as a manifestation of a deeper disharmony.

Whilst Chinese Medicine has been treating psoriasis for thousands of years, there has yet to be very much scientific research done on its effectiveness for this condition. One large scale Chinese study of 600 psoriasis patients treated with TCM found substantial improvement, with at least 60% of the skin rash disappearing, in over 500 of the patients, with 370 of these classified as ‘cured’.

Finally, a little story about one of our patients. She initially came for treatment for Raynaud’s disease – she felt the cold very easily, and especially her hands and feet would get painfully cold. We treated her with acupuncture and moxibustion (where we warm the acupuncture point and body tissue surrounding it with the herb artemisia vulgaris, or mugwort), aiming to stimulate and invigorate the flow of Qi through her limbs. After three or four treatments this was working very well, and we suggested that we might also be able to help with her psoriasis, which she had been suffering from for most of her adult life (she was in her mid-60s). She was surprised to hear that we could treat psoriasis and, buoyed by the improvement in her health so far, keen to find out if it would help; she had been used to keeping her arms and legs covered whatever the weather, and did not feel able to do things like go to the swimming baths. .

From our point of view, in this case there was a definite link between the cold limbs and the psoriasis, both being at least in part due to impairment of the flow of Qi through the limbs, resulting in coldness and lack of nourishment to the skin. Again the treatment proved effective – although for a while there were occasional flare-ups of the psoriasis, in general there was a big improvement, which we managed to sustain with monthly ‘top-up’ treatments. You can read this patient’s own words (and those of her grateful husband!) here.

Demystifying Chinese Medicine: What Have the Kidneys Got to Do with Fertility?

Many people seeking help to enhance their fertility are turning to Traditional Chinese Medicine (TCM), but may be surprised to hear that part of the treatment, at least, is targeted at the Kidneys. After all, from a  western medical point of view, the kidneys have little to do with fertility (although, for example, the importance of the adrenal glands, that sit at the top of the kidneys,  in regulating a number of vital physiological processes will have knock-on effects on reproductive health.)

So what have the Kidneys to do with fertility? To understand this, begin by noticing the upper case ‘K’ in the previous sentence – this is not a typo! We are following a convention to capitalise the first letter of an organ when we are referring to that organ as understood by TCM, for indeed TCM sees these organs rather differently to western medicine. In particular the organs in TCM are thought of more in terms of their functions and less in terms of their structure. Indeed we could go so far as to say that in TCM the organs are a set of functions.

So when we talk about the Kidneys in the context of reproduction, you may need to temporarily forget what you may know about the kidneys as understood by western medicine, and think in terms of some of the functions that are denoted by the word Chinese  ‘Shen’, which translates as ‘Kidneys’. When we say that we need to treat the Kidneys what we mean is that we need to regulate or enhance some of the functions of the Kidneys.

One of the main functions of the Kidneys in TCM is to store ‘Jing’ (sometimes translated as ‘Essence’) If you are familiar with the concept of Qi in TCM (and in Chinese culture generally) you can perhaps think of Jing as a condensed form of Qi which is the root and foundation of human life – for this reason the Kidneys are called ‘the Root of Life’.  Jing governs growth and reproduction – someone with abundant Jing will be well developed, have a strong constitution and be very fertile; good Jing means strong sperm, strong eggs, and strong, healthy children.

Jing has two sources. The first is called pre-natal Jing, and comes from our parents, as a union of their Jing at conception; sperm and eggs being manifestations of Jing. So our Jing depends to a large extent on their Jing, and in particular their health at the time of our conception, and in this way it constitutes our link with our ancestral lineage, our inheritance. More prosaically, it is the hand of cards we are dealt at birth. Some of us inherit strong Jing, whilst others of us have more of a challenge! However, it is not just a question of the cards you are dealt, but how you play them. Abundant pre-natal Jing can be squandered by an unwise and unbalanced lifestyle, whilst someone with weaker pre-natal Jing can , through prudent husbandry of their resources, live a long, healthy, productive (and reproductive) life.

The second source of Jing is eating and breathing; this is post-natal Jing. The weaker our constitution, the more care we need to eat and breathe well. (You might think that breathing just happens automatically, but that is not entirely true – our breath can be full and natural or constricted and shallow, and of course there is also the question of what it is we are inhaling; pure air, smog or smoke!)

So whilst our Jing is partly dependent on factors out of our control, how we live still has a significant effect. Jing can be depleted in the following ways:

i)                    Chronic (i.e. long term) disease will eventually deplete the Kidneys, because it drains our deeper resources. But of course this can be mitigated, at least to a degree, by how well we manage such a disease.

ii)                   A lifestyle which involves us repeatedly ‘running on empty’ depletes Jing. When we ‘run on empty’, what we actually run on is Jing, our deepest resources of energy stored in the Kidneys. This is OK from time to time, but if it becomes an ongoing or regular thing, as is often the case with modern lifestyles, our reserves will dwindle, and signs of Kidney deficiency will start to emerge.

iii)                 For a woman, the Kidneys may be depleted by too many pregnancies too close together, or by a failure to nourish herself and conserve energy after pregnancy. In TCM a woman who has given birth needs to rest and replenish their Kidney energies (as does a woman during her period and a woman entering the menopause – these three times are referred to as the three opportunities, in that they are times when a woman can actually enhance her health by appropriate nourishment and rest – or else damage it by the opposite.) From this point of view a modern tendency to rush back to work straight after childbirth (see our other blog entitled “Woman and Superwoman…“) is seen as somewhat foolhardy.

iv)                 As for men, their Jing can be depleted by excessive sex, although what counts as excessive may vary from one individual to another, and is also, obviously, dependant on the age of the man in question.  The ‘bedroom arts’ of the Taoist tradition in China include sexual techniques to enable men to have sex without losing Jing.

v)                  Jing also declines with age, which is why women (at least) become less fertile as they get older. Of course ageing is natural, but once again it is a process which can be managed well or not so well.

Life being what it is, it is therefore not surprising that many people suffer from some degree of Kidney deficiency. This may present itself either as a deficiency of the Kidney Yang, or of the Kidney Yin, and is often responsible for fertility problems.

Fortunately there is a lot that can be done to support and strengthen the Kidneys, and thus to boost fertility.

i)                    Acupuncture and moxibustion: Chinese medicine has been used for millennia to help people nourish their deepest energies, their Jing. We can avail ourselves of this accumulated practical wisdom by having regular acupuncture treatment with someone trained in TCM.

ii)                   Diet –  as we have seen, food is a key source of post-natal Jing. To nourish the Kidneys, we need to ensure we are eating a wide base of essential nutrients.

iii)                 Chi Kung – the Chinese have developed forms of exercise to help us conserve Kidney energy: some Chi Kung and martial arts traditions include practices to help to preserve pre-natal and build post-natal Jing.

iv)                 Sleep and rest – sleeping well and sufficiently is vital if we are not to run down our deeper resources. If we have trouble with insomnia, it is important to get some help so that we sleep well for this reason link.

v)                  Avoid over-working – easier said than done. If we do have to work long hours, we would do well to avoid making ourselves busy in our leisure time, in a common but misguided attempt to cram in as much satisfaction as we can. Try doing nothing from time to time.!

In an age of instant gratification, we may also need to realise that the deep energies of the Kidneys, if they have been run down, can only be restored gradually.  Conversely, a life which values those energies and does not fritter them away and which takes care to nourish and support them is a healthy and fruitful life.

Demystifying Chinese Medicine – Yin and Yang

If you know anything at all about Chinese Medicine, or about the classical Chinese culture that it grew out of, it is probably the words Yin and Yang. The T’iai Chi Tu symbol, depicting the way Yin and Yang harmonise with each other, appears frequently. I even knew an accountant who had it on his business card! I guess balance is important in accounting too!

Yin and Yang are indeed key concepts in Chinese Medicine, but what do they really mean? Is it just a lot of mystical hot air?

The concepts originate in the observation that many aspects of the natural world are bipolar, they have two opposite poles. Day and night. Hot and cold. Up and down. Earth and sky. Winter and summer.  This is something so obvious it can be overlooked. Yang corresponds to daytime and therefore to warmth, light and movement. Yin is night-time, cold, dark, still. By extension, Yang is energy and consciousness, Yin is matter and substance.

In human life too the same thing is observed: inhaling and exhaling, systole and diastole, waking and sleeping, talking and being quiet, working and relaxing,  we move between opposites all of the time. The ancient Chinese, however, developed this apparently banal observation into a rather sophisticated philosophy of life which encompasses not just medicine but everything from martial arts to flower arranging.

When applied to medicine, this leads to the crucial idea, somewhat similar to the rather neglected western medical notion of homeostasis, that health involves maintaining balance. If Yin and Yang are harmonised in our body, in our mind, in our life, we are healthy people. Lose this balance for some reason, and illness results. The balance is not a static one, however; as the T’ai Chi Tu illustrates, Yin and Yang are inter-dependent, fluidly transforming into each other in the same way as day gradually gives way to night. A healthy person moves from Yin to Yang and back again in harmony with their environment.

Still, that is all a bit vague perhaps. It becomes more concrete when we start to apply it to specific aspects of the human being. For example, consider the blood. The Yang aspect of the blood is its movement; the Yin aspect is the actual substance of the blood, what it is made up of.  Clearly we need both; the blood needs to circulate and flow freely, and it needs to contain enough oxygen and other nutrients. If the Yang of the blood is lacking, we may have circulation problems such as Raynaud’s disease. If the blood is Yin deficient, we may, for instance, have anaemia.

As with the blood, so with any aspect of our being; we can speak of the Yin and Yang of the digestive system or of the kidneys; of the food that we eat and of our daily routine; of our constitution and of our temperament; of our body weight and of our body temperature. Ill health from this perspective starts to arise when, at some level of our being, we start to get out of balance. Maybe this initial disharmony begins in our emotional life or with poor eating habits; maybe it begins with an adventitious infection or with overdoing it at work. To begin with we can probably cope but, if we do not take steps to put things right, eventually our ability to self-regulate can be overwhelmed and imbalance starts to take root, and this has a knock on effect throughout our system.

To take an example, suppose we get into the habit of working late into the evening and not getting enough sleep. Maybe we use caffeine or some other stimulant to keep this up. After a few months of this we start becoming irritable and edgy, but we choose to ignore this. As well as not giving our self sufficient time to rest, we now find that the quality of the sleep we do get is not so great. Alarm bells are ringing, but we are choosing to ignore them!

As time goes by, our palms are becoming sweaty, and we have lost weight; we have a bit of a dry mouth a lot of the time, and a tickly cough. Sometimes at night we feel our heart fluttering, which finally wakes us up to the fact that we ought to get some help.

From the classical Chinese perspective, we have been giving the Yin side of our nature a bit of a hammering. When we should have been relaxed or asleep (Yin) we have been awake and active (Yang). To achieve this we have been using a Yang stimulant (caffeine) at the time of day when Yang should be taking a back seat.

So we end up without enough Yin. We are undernourished and over tired. Since Yin is related to stillness and calm, we are edgy and nervous. Sweaty palms, insomnia, weight loss, a dry mouth and a tickly cough are all classic signs of Yin deficiency, as are heart palpitations that happen in the evening. A practitioner of Chinese medicine will probably consider that the Yin deficiency relates especially to the kidneys, lungs and heart.

To restore health we clearly need to make some changes to our lifestyle; in particular we need to nourish the Yin by giving ourselves time to rest, perhaps by learning (again) to simply be for a bit, without so much doing (if we have been overworking because we need the money, this may be challenging, but not as challenging as what will be happening further on down the road if we don’t take ourselves in hand!). We may also need some treatment to help us; in Traditional Chinese Medicine this may be some acupuncture to calm the mind and nourish the Yin of the heart, kidneys and lungs, maybe also some herbal Yin tonics, and some advice on foods we can eat to nourish the Yin. Qigong or meditation are also a good idea.

Now the human being is a complex thing, and most health problems are not a straightforward case of Yin deficiency or Yang deficiency – or of Yin or Yang excess for that matter. Often the picture is complex and it takes some skill to fathom the ways in which Yin and Yang are out of kilter. There may, for instance, be Yin deficiency in one part of our system and Yang deficiency in another part. It becomes more complex still when we consider that one of the principal characteristics of Yin and Yang is that they transform into each other, as the day passes into night and an arthritic finger joint becomes hot and painfully inflamed if exposed to cold weather.

The human being is an incredibly complex system of inter-relationships and balances, and a big part of the art of healing is for the clinician to perceive just where the fundamental disharmony lies, so that when this is rectified by the appropriate treatment everything else falls into place and we start feeling ourselves again. One of the characteristics of this traditional Chinese medical approach is thus that it looks to treat the disharmony at the root of our problem, rather than just giving symptomatic relief which is not likely to successful in the long run; either our symptoms will return, or new ones will take their place.