Skya GardnerAbbate, DOM
Executive Director, Southwest Acupuncture College
Gentle Treatment for General Anxiety Disorder, Posttraumatic Stress and Episodic Anxiety
As the Lingshu so wisely stated centuries ago, "To every needling, the method is above all not to miss the rooting in the Spirits. To be effective and at the same time not to violate the organism goes all the way to the origin of the patient's life, to the place where the Spirits are rooted.
"The Spirits, vacillating under the emotional shock of apprehension and worry, are no longer guarded in their place and can no longer guarantee the person. There is a dispossession of that which makes the person; one loses possession of oneself."1
These ancient and astute words certainly speak to our times, not just for the 10 million Americans who suffer on a daily basis from generalized anxiety disorder (a sustained acute disorder defined as lasting six months or longer), but likewise the millions who experience posttraumatic stress (defined as symptoms persisting for longer than a month after a traumatic or catastrophic event) and episodic anxiety (a normal type of anxiety linked to an extraordinary life event). Such anxiety can be overwhelming to the person and can manifest as further social isolation; uncontrollable worry; tension; irritability; fatigue; muscular aches and pains; sleep disorders; restlessness; extreme anxiety; numbness to the event; palpitations; and being easily startled.
While each of these varieties of anxiety have nuances in terms of their definitions, they share more in common than not. Western treatments tend to center around prescription drug therapy to assist in restoring chemical balance to the brain. Most of these drugs are meant to be used in the shortterm; some can become addictive, such as benzodiazepines like valium and ativan. Many produce other undesirable sideeffects such as decreased appetite; dry mouth; sweating; constipation; tremor; fatigue; sexual sideeffects; and more.
Dr. Allen Keller, a primary care physician at New York's Bellevue Hospital who heads up a group called Survivors of Torture, recommends the following mechanisms as ways to cope with these disorders:
1. Encourage the patient to maintain social connections in the wake of these problems.
2. Don't force the patient to talk about the traumatic event that is affecting them. (The keyword here is force my italics.) However, allow them to talk about it even if all you can do is listen. You do not have to have a solution, just a compassionate ear.
3. Acknowledge the person's experience of the event and support them in their experience over emphasizing the medicalization (somatatizing) of their condition.
4. Periodically check in with the person on the somatic symptoms of their distress.
As practitioners, I believe these principles can be applied by us as well. This is not to say that the experience of anxiety is not real, nor that the somatized symptoms are likewise false, for they are very real physically and can be problematic to the functioning of the person and his or her health. Our aim as
practitioners is to bring them back to balance. The strength of our medicine is twofold: its energetic paradigm, which recognizes patterns of disharmony, and the gentle treatment tools we employ.
While a nonspecific stress reaction serves to disturb the flow of energy in the body, a specific stress reaction may involve various zangfu organs. They typically involve the liver, spleen, heart, lung and kidney. The correct differentiation of signs and symptoms can reveal their roles. Such stress can lead to symptoms of stagnation, particularly of the blood. Various acupuncture points may be selected for treatment based on proper discernment of the pattern of disharmony, with the generalized aim of treatment to move the blood, strengthen the organs (if need be), and redistribute and balance the qi.
In my experience with all three varieties, both personally and professionally, I have found that there is room for the judicious use of Western medications for the initial phase of shock and stabilization, the therapeutic advice of stress experts, and the unsurpassed efficacy of acupuncture for rebalancing the patient's energy and promoting recovery.
Certainly as practitioners, we must treat what we see and do no harm, so there are no set formulae for treatment. Treatments should be conservative (that is, the use of few needles). My repertoire of preferred point selection includes the ones that follow. For space considerations and clinician convenience, their unique energetics, preferred locations and needling techniques are summarized in table format. Due to the nature of the problem being addressed, and for patient comfort, use #1 30mm Seirin needles. Needles may be retained for 1015 minutes.
In summary, Oriental medicine has tremendous clinical relevance for the normal stresses of daily life and the inordinate stresses of the 21st century. It is efficacious physically and psychologically, yet gentle, and nourishes on the deepest level of our existence the Spirit.
1. Quoted in Rooted in Spirit, by Jean Claude Larre and Elizabeth Rochat de la Valle. Barrytown, NY: Station Hill Press, 1995, pp. 45.
Skya GardnerAbbate, DOM Executive Director, Southwest Acupuncture College Santa Fe, New Mexico
Editor's note: If you would like to comment on Dr. Abbate's article, please contact Acupuncture Today by fax (714) 8994273 or email (Editorial@AcupunctureToday.com). You are also encouraged to discuss Dr. Abbate's article at her "Talk Back" forum at www.AcupunctureToday.com/columnists/abbate.