Historical Integration of Neuropsycholoogy Concepts in TCM: The Three Levels of the Psyche

One of the most enjoyable aspects of integrating a neurologically informed approach to Traditional Chinese Medicine (TCM) is contemplating how our predecessors might have described these concepts in the classics, even without the knowledge of modern neurology. When utilizing classical texts such as the "1000 Ducats," the "Su Wen," or the "Ling Shu," it is essential to consider the perspective of the individuals who authored them. These classics were often not the work of a single individual but were compiled, edited, and expanded over time. As Jeffrey Yuen emphasizes, understanding the cultural and historical context is crucial for accurate interpretation and application.

Redefining QI to include Patency: The ECM and Cellular Respiration

Traditional Chinese Medicine (TCM) emphasizes the balance of energy within the body and offers a holistic approach to health. Early practitioners used language that incorporated the cultural, spiritual, and environmental understanding of their time. As medical science advances, we can broaden our understanding of the qualitative aspects of our medicine with contemporary insights to enhance our approaches to treating various conditions, including chronic pain, spasticity, and neurogenic trauma.

TCM Fight/Fight and Sympathetic Dominance

Now that we have explored the basics of Yin and Yang balance as reflective of the Autonomic Nervous System's function, we are better positioned to understand the fight-flight mechanism within the TCM framework. In this context, the fight or flight response can be viewed as a condition that arises when there is a significant disruption in this delicate balance. Such disruptions overwhelm the ANS, tipping the scales away from harmony and leading to the profound physiological and psychological changes observed in chronic stress responses. This TCM perspective allows us to conceptualize trauma not just as an emotional or psychological event, but as a systemic physiological condition that challenges the body's innate capacities for regulation and balance. In Traditional Chinese Medicine (TCM), the fight or flight response is viewed through the lens of Qi and Blood mobilization to prepare the body for immediate action. When an individual faces acute stress, Qi and Blood are directed towards large skeletal muscles below the trunk, the leg-yang channels, which are associated with activity and movement. This redirection supports rapid muscular response that, when unresolved, leads to patterns of spasticity and tension that are visibly manifested in the fascia. 

Best. Available Technology

One of the hurdles I faced as a former research scientist practicing Traditional Chinese Medicine (TCM) was the lack of clinical testing, clear objective markers, or scientific proof proving the efficacy of our medicine. This gap in scientific validation has led to skepticism and a lack of acceptance within the broader medical community. 

To remain relevant, especially as our autonomy is being encroached upon by MDs and physical therapists performing dry needling and trigger point work, we cannot shy away from these conversations. Since the beginning of my practice over 20 years ago, I have used laboratory tests to confirm the efficacy of treatment, particularly for patients with autoimmune diseases, endocrine issues, kidney neuropathy, and catastrophic diagnoses. This approach provided concrete evidence of clinical recovery, which was crucial for me as a new provider.

Introduction to George Soulié de Morant

When I began my work on vestibular and primitive reflex training, I found it perplexing that, given the significance of cranial nerves and their influence on the autonomic nervous system, particularly their presence in the brainstem and cervical spine, there were no acupuncture points between GV 14 and GV 15. This seemed illogical, given the extensive knowledge and depth of our medicine.

Spasticity: A Western Perspective and Historical Context

Spasticity, characterized by increased muscle tone and stiffness, has long been recognized in Western medicine as a significant clinical challenge. It often results from conditions affecting the central nervous system, such as stroke, multiple sclerosis, and cerebral palsy. The traditional Western approach to managing spasticity includes pharmacological interventions, physical therapy, and sometimes surgical procedures to alleviate symptoms and improve functional outcomes.

Management of Spasticity: The Sinew Channels (jing jin) in Traditional Chinese Medicine

Providing effective treatment in TCM for patients with neurogenic trauma and spasticity involves a deep dive into the ancient wisdom of the sinew channels (jing jin), which are integral to the circulation of Wei qi that permeates muscles, tendons, and the entire fascial network. Historically, treatments focusing on these channels, as taught by Sun Simiao and detailed in texts like the "Ling Shu," were central to managing external pathogenic factors and systemic health issues. Sun Simiao, a renowned Chinese physician of the Tang Dynasty, emphasized the importance of maintaining the health of the sinew channels for overall physical well-being. He provided detailed descriptions of various techniques to treat disorders related to these channels, such as acupuncture, moxibustion, and herbal therapies, highlighting their role in managing pain, enhancing mobility, and restoring balance within the body.

TCM Challenges with Sympathetic Dominance and Limitations of Current Care

Without an understanding of the fight-flight response, many acupuncture practitioners exacerbate issues of sympathetic dominance in these cases. Once muscle tightness and rigidity have set in with an orthopedic case, many practitioners, including acupuncturists and clinicians performing trigger point dry needling, may find their treatments are not only ineffective in permanently resolving these conditions but also produce unnecessary pain. Resetting a motor point, (as done in acusport styles and practitioners of trigger point therapy), only provides a temporary solution because the underlying issue originates from more primitive regions of the brain and spinal cord. Directly resetting at the site of the muscle is ineffective until we restore proper vagal tone through flexion and contraction patterns in the body. [1] MDs and chiropractors who use prolotherapy often achieve better short-term results only because steroids and transdermal lidocaine provide a numbing effect to the local area, without ever addressing the underlying tissue spasticity, hence the need for repeat visits.

Beyond Polyvagal Theory: Addressing the Missteps in Pharmaceutical Interventions

As a pathomechanism, chronic fight-or-flight (sympathetic dominance) inhibits the rest and repair process by reducing white blood cell activity, which is essential for laying down new tissue. High circulating stress hormones cause oxidative stress, creating a more acidic environment that shifts tissue composition towards more bone-like qualities. An ECM that is too acidic leaches bone tissue (Ca++) to maintain a neutral pH, leading to bone loss (early osteoporosis). And once primitive reflexes are reactivated, the impulses from the vagus nerve are blocked through the brainstem. Once spasticity develops in the cervical spine, we become yang dominant (sympathetic) and functionally hypoxic.