Healing Starts in the Heart

Treating posttraumatic stress disorder with traditional Chinese medicine
By Mary Ann Petersen, LAc, Dipl.OM

Many events can lead to posttraumatic stress disorder (PTSD). War is the most well-known cause, and PTSD is a leading problem among our veterans. But, there are other experiences that cause PTSD, things like rape, assault, accidents, and natural disasters. With this in mind, it is not surprising that an estimated 7.7 million Americans have been diagnosed with it. This amounts to a lot of people who need help.

Corbin Sweeney is 55 years old and has lived with PTSD for the majority of his adult life. He has had no specific treatment for it. Here are his own words about his experience:

Peaceful sleep is a rare thing, and depression very common and long-lasting. It’s not that I am not here—not here as a piece of the bright star of life that shines in all of us—but I exist in a muted form, often lost in the haze. It has manifested as a life of survival and patterned reactivity. My life energy is ritualized to cope, and often poorly at that.

To be able to name it, and know other people struggle with similar issues and feelings, gives a touch point of reference, but little else.

I have never addressed this issue in a focused way with a health practitioner. I have only tried to deal with the health symptoms. They are many, and they remain, for treatment often doesn’t quite go to the quick of the matter, which is, I believe, the need for a soul healing.

Because PTSD doesn’t go away quickly or easily, people need treatment that helps them in a long-term way to cope and manage their lives. Getting through it takes time and effective treatment methods.

Regarding healing, in her excellent book Operating Instructions: A Journal of My Son’s First Year, Anne Lamott wrote, “Everyone wanted me to get help and rejoin life … I wanted to, but I just had to lie in the mud with my arms wrapped around myself, eyes closed, grieving, until I didn’t have to anymore.” If we all had time, perhaps lying peacefully and partially submerged in the mud could work. Such an earthy and calm approach is appealing. No side effects either, except mud-stained clothing.

Most PTSD patients are treated either through antidepressants or talk therapy, but there are other options. I am going to explain how I treat PTSD using traditional Chinese medicine (TCM).

TCM has been addressing mental health for centuries. The early practitioners didn’t refer to it as “treating mental health,” they said they were treating the shén (spirit) or disturbances of the shén. The shén was understood to live in the heart. The heart, therefore, was often the center of healing.

But this idea is not only an ancient Chinese concept. The American thinker and writer Carl Townsend wrote, “All healing is first a healing of the heart.” The heart needs calming and the mind needs clearing. With TCM we can attend to both in a single treatment, using meridians that travel through the heart (spirit) and mind.

My acupuncture points choices

GV 20 - Baihui Let’s start at the top—literally. Governing vessel 20 is located at the crown of the head, in the center, nearly between the ears. Its name is Baihui, which has been translated as “hundred meetings,” “mountain of heaven,” and “ghost gate.” Classical texts refer to this point for “disorders of the spirit.” Among other things, it treats heart palpitations, disorientation, and sadness. This point has a close relationship with the brain and heart as the governing vessel (the meridian that GV 20 is based on) internally passes through the brain and heart. I pick this point to clear the mind and calm the heart of the patient.

GV 24 – Shen Ting Moving a few inches forward, near the anterior hairline, the next point is governing vessel 24. It is called Shen Ting, which translates to “courtyard of the spirit.” It has a strong action to calm the spirit. Both GV 20 and 24 are also said to help to clear pathogenic heat. TCM often describes disorders as having temperatures, both hot and cold. The channel may be blocked either with coldness leading to pain, or heat leading to anxiety and panic. In this case, we want to clear heat.

Yintang Traveling a few more inches forward and down, the next point centers between the eyebrows. It is called Yintang, translated as “hall of impression.” Yintang is described as a powerful and effective point to calm the spirit in the treatment of insomnia, anxiety, and agitation. This point location is referred to as the third eye by many traditional cultures.

CV 12 and 14 – Zhongwan and Juque The stomach plays an important role in physical and emotional health. The conception vessel meridian travels through the center of the body. The external path goes straight down the middle of the torso. I would use CV 12 and CV 14. CV 12 is Zhongwan, which means “middle cavity.” CV 14 is Juque, which means “great gateway.” These points are around four to six inches above the umbilicus. CV 12 has a connection to the stomach: CV 14 connects with the heart. CV 12 is said to address “injury by worry, anxiety, and overthinking” as well as “injury by the seven emotions leading to epigastric pain.” It is also indicated for the treatment of diarrhea, another symptom of PTSD. TCM has long recognized the connection between emotional harmony and a smooth functioning stomach. Because CV 14 provides a sort of door and support to the heart, it is naturally a good choice.

PC 6 - Neiguan For good measure, I would add Pericardium 6. It is called Neiguan, which means “inner pass.” This point is on the inner wrist and is known for helping with seasickness and for all types of nausea. It is considered to be helpful for the heart, not only emotionally, but also physically. Interesting to note, this point is considered a primary point to use for analgesia during chest surgery. I include it because it is indicated for “palpitations, fear, sadness, insomnia, and apprehension.” It also relates to the liver, and the “stagnation of liver qi,” which, in this case, means stagnant emotions. The goal is to release the hold of the negative emotions.

LV 3 – Tai Chong Last, but not least, I would choose LV 3, Tai Chong, translated as “great rushing.” This liver meridian point is down on the foot, between and above the first and second toe. This is a major point indicated to spread and subdue liver energy. The liver is considered to control parts of our emotions, in particular anger and frustration. It is used for depression, insomnia, fearfulness, headaches, PMS, and several other conditions. It is a major point for moving things, in this case, the stagnation of negative emotions. It is a good point for treating stress in general.

The above points are my favorites though I might make different choices, depending on the patient. I treat people individually, focusing on their needs. These points have been outlined to provide a sampling, with an explanation for an “average” treatment.

Acupuncture has had long acceptance in the east, but it is now gaining more widespread acceptance in the west as well. It has even been picked up by the military and Mayo Clinic.

The military

The military is already using acupuncture to treat PTSD as well as other health issues, including battlefield injuries. For active-duty soldiers with PTSD, it is considered useful because it calms and settles the soldier, but does not numb or sedate like some medications. The soldiers need to be calmed down, yet alert at all times.

PTSD programs launched at Fort Bliss in El Paso, Texas, in 2007, were among the first comprehensive efforts of their kind in the military. It was an integrative approach, combining alternative and traditional treatments for soldiers with PTSD. Today there are more than 15 programs up and running across all branches of the military. The Department of Defense has said that early results from these programs have been extremely positive.

I met military medical personnel (MDs) while attending medical conferences and asked them about their experiences integrating acupuncture in military health care. I wanted to talk directly to those who actually use it in the field. The physicians I spoke with were matter-of-fact about it, stating four reasons they approved of its use: it works, is low cost, integrates easily, and complements traditional treatments.

Mayo Clinic

The Mayo Clinic’s website states that acupuncture may be helpful in improving the symptoms of PTSD. The clinic has acupuncturists on staff. They stress the need to get treatment sooner than later, as it may provide a better outcome, shortening the length of PTSD. Anxiety, depression, and panic attacks are classic symptoms of PTSD, but Mayo lists other symptoms as well, including fatigue, exhaustion, a lowered immune system, body aches, diarrhea, loss of appetite, and muscle weakness. All of these symptoms can benefit from acupuncture treatment.

A typical treatment

To get the idea of what a treatment looks like, picture the patient either in a recliner or on a massage table, lying on their back. The room is quiet, or there may be soft music playing. The room has a soft light and is a comfortable temperature. After the needles are inserted, the patient usually settles into a relaxed state. One patient commented that the feeling of the treatment reminded him of what it was being in “the zone” while he cruised on his motorcycle on a country road: smooth, calm, meditative. A session may last from 30 to 60 minutes. Patients who normally have trouble sleeping may fall asleep during treatment. Every element around treatment is soothing. To achieve a calm spirit, every element needs to be calm.

How many treatments are needed—and how often—depends on the patient. For severe cases, I might start with two to three weekly for a month. Then they might be reduced to one or two a week for another month. After that, once a week for up to a month. Some patients could do well with even just one treatment weekly for a few weeks. Others might need it for months. Acupuncture works well when administered regularly and on a schedule. In this way, it is not different than drug therapy or talk therapy. It builds on itself as it works to adjust and affect the patient.

Once the change or healing occurs, a patient may or may not need appointments to maintain it. Many patients keep the progress that is made with acupuncture. Through the treatment, they often learn to use other self-healing tools like meditation. Acupuncture can help them get to that place.

 

Mary Ann Petersen, LAc, Dipl. OM practices acupuncture at Good Medicine in Eugene, Oregon.