Happy and Healthy： Considering the Role of Emotions in Maintaining Health

Insights into Studying Traditional Chinese Medicine

Column Introduction: This is a new section in our magazine, aiming to introduce the experiences and clinical insights gained from studying traditional Chinese medicine. The articles are contributed by students from international schools of traditional Chinese medicine, clinical doctors in traditional Chinese medicine, and various individuals with experiences and stories related to traditional Chinese medicine. It serves as a platform for communication among readers, doctors, and students who are interested in Chinese medicine.

Jeffrey T. McKean, Bing Yang

Traditional Chinese medicine has been in use for thousands of years and is comprised of a variety of manual therapies and herbal formulations, the uses of which are guided and supported by an astonishingly complex and thorough theoretical framework. One of the strengths of this framework lies in its holistic view of the human body and the ways in which optimal health and wellness are intimately connected to, interwoven with, and affected by not just our physical world, but our spiritual and emotional worlds as well. But what does current research have to say about this aspect of Chinese medical philosophy? With the benefit of sophisticated study designs and the modern scientific method, does this view of “emotion as pathogen or therapeutic force” hold up to scrutiny? These questions are considered below.

Unlike Western allopathic medicine, traditional Chinese medicine has from its earliest beginnings considered emotions to have a profound effect on health, either in a supportive or detrimental way depending on the particular emotions experienced and with what frequency they are felt. The earliest reference to a link between emotional wellbeing and overall health is found in The Huang Di Neijing, which represents the first compilation of medical knowledge within China and the start of traditional Chinese medicine’s canon of classic texts. In chapter two it is advised that in the summer “it is important to be happy and easygoing and not hold grudges, so that the energy can flow freely and communicate between the external and the internal. In this way illness may be averted in the fall” (Ni, 1995, p. 5). Furthermore, later in this same chapter it’s stated that “just as the weather in autumn turns harsh, so does the emotional climate. It is therefore important to remain calm and peaceful, refraining from depression so that one can make the transition to winter smoothly…Also, one should refrain from both smoking and grief, the emotion of the lung. This will prevent kidney or digestive problems in the winter” (Ni, 1995, p. 6). These two passages make it clear that from the traditional Chinese medicine point of view, positive emotions can help maintain health while negative emotions put one at risk of developing illness. Not only does this medical philosophy see a link between emotions and health, but it also sees a link between health and the seasons, suggesting that certain emotions are more appropriate for certain seasons. Amazingly, though these concepts were conceived of by the Chinese several thousand years ago, modern research does in fact seem to support these notions. One study conducted by researchers at the University of Cambridge compared study cohorts based in the United Kingdom and Oceania and found that genetic changes occurred within immune cells in response to the season and climate (Dopico et al., 2015). This suggests that our natural immunity does indeed respond to the changing of seasons, ensuring that our bodies are best prepared to fend off illnesses which may be more prevalent at one time of year than another.

In chapter thirteen of The Huang Di Neijing, it also states that, historically, people had lived in such a way so that “their emotions were calm and peaceful, and they were without excessive desires…they maintained jing shen nei suo, or inner peace and concentration of the mind and spirit. This prevented the pathogens from invading” (Ni, 1995, p. 50). Here again we see a reference to the healthpromoting and illnessprevention qualities of positive emotions and mental stability, and again there does seem to be support for these ideas. One systematic review of RCTs looking into the efficacy of meditation and mindfulness as therapeutic tools did, in fact, find some evidence that these practices are associated with changes in certain biomarkers of immune system activity and could potentially have positive effects on health (Black & Slavich, 2016).

In contrast to what appears to be a wealth of scientific literature supporting the connection between emotions and health, the opposite seems to be true with respect to reliable peer reviewed sources providing evidence to the contrary. However, despite this overall dearth of academic literature, one study titled The Psychological Health Benefits of Accepting Negative Emotions and Thoughts: Laboratory, Diary, and Longitudinal Evidence did provide at least some support for the opposing view. In general, the study found that those who accepted their negative thoughts and emotions, instead of judging or attempting to avoid them, may enjoy better psychological health in the long run. Likewise, there was evidence suggesting that individuals who practice acceptance of negative thoughts and emotions might actually end up experiencing less of these as a result. And finally, study participants who practiced acceptance were found to respond to stressful situations in ways that did not exacerbate negative thoughts or emotions associated with the stressor(s) when compared to participants who did not practice acceptance (Ford et al., 2017). All these findings suggest that quite the opposite of traditional Chinese medicine’s view of the connection between health and emotions is true. Whereas, in traditional Chinese medicine, experiencing stress will lead to Liver Qi stagnation and the negative symptoms associated with it, and grief and sorrow will lead to symptoms of Lung Qi deficiency, the view supported by the above study would say that experiencing these emotions, in fact, will actually increase overall health and wellness.

Though there is evidence to argue both in favor of and against the theories found in traditional Chinese medicine regarding the emotions and their effect on health and wellbeing, the difference between amount of evidence supporting each view is drastic. To that end, it makes its quite hard to conclude anything other than that the ancient Chinese were able to recognize the connection between health and the emotions, as well as its importance, thousands of years before Western allopathic medicine began to even wonder at whether a connection existed at all. Even in the absence of any supportive scientific literature, in the end, perhaps the best indicator that such a connection exists are the voluminous number of practitioner case reports dating to antiquity which indicate it does, as well as many century’s worth of patient experiences.

About the author:

Jeffrey T. McKean is a recent graduate of the New England School of Acupuncture (NESA) where he received his Master of Acupuncture and Chinese Herbal Medicine. He previously received a Bachelor of Music in Songwriting with a minor in Drama from Berklee College of Music and is currently a candidate for Doctor of Acupuncture at NESA.

Bing Yang is an acupuncturist in Massachusetts. She received her bachelors and Master’s degrees in Acupuncture and Chinese Medicine from Beijing University of Chinese Medicine in the 1990s and her Doctoral degree from Massachusetts College of Pharmacy and Health Sciences (MCPHS). Currently she is the associate professor and Director of Chinese Herbal Programs of New England School of Acupuncture, MCPHS. She also maintains a private practice in Boston.

Resources

Black, D. S., & Slavich, G. M. (2016). Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Annals of the New York Academy of Sciences, 1373(1), 1324. https://doi.org/10.1111/nyas.12998

Dopico, X. C., Evangelou, M., Ferreira, R. C., Guo, H., Pekalski, M. L., Smyth, D. J., Cooper, N., Burren, O. S., Fulford, A. J., Hennig, B. J., Prentice, A. M., Ziegler, AnetteG., Bonifacio, E., Wallace, C., & Todd, J. A. (2015). Widespread seasonal gene expression reveals annual differences in human immunity and physiology. Nature Communications, 6(1), 7000. https://doi.org/10.1038/ncomms8000

Ford, B. Q., Lam, P., John, O. P., & Mauss, I. B. (2018). The psychological health benefits of accepting negative emotions and thoughts: Laboratory, diary, and longitudinal evidence. Journal of Personality and Social Psychology, 115(6), 1075–1092. https://doi.org/10.1037/pspp0000157

Maoshing Ni. (1995). The yellow emperor’s classic of medicine : a new transl. of the Neijing Suwen with commentary. Shambhala.

學習傳統中國醫學的體會

欄目介紹：這是我們雜誌新開的一個欄目，目的是爲了介紹學習傳統中醫的體會和臨床經驗，文章來源於國外中醫學院的學生、中醫臨床的醫生和各種傳統中國醫學的經驗以及故事。爲所有對中國醫學感興趣的讀者、醫生、學生們提供一個交流的園地。

快樂和健康：情緒在維持健康中的作用

杰弗裡·麥基恩 楊冰

傳統中醫已經使用了數千年，由各種手法療法和草藥配方組成，其使用受到極其復雜和徹底的理論框架的指導和支持。該框架的優勢之一在於它對人體的整體看法，以及最佳健康和保健與我們的物質世界以及我們的精神和情感世界密切相關、交織和影響的方式。但目前的科學研究對中醫哲學的這方面有何看法呢？憑藉精密的研究設計和現代科學方法，這種“情緒作爲病原體或治療力”的觀點是否經得起推敲？本文討論這些問題。

與西方的對抗療法不同，傳統中醫從一開始就認爲情緒對健康有深遠的影響，無論是支持還是有害，取决於所經歷的特定情緒以及感受到這些情緒的頻率。最早提到情緒健康與整體健康之間的聯係是在《黄帝内經》中，它代表了中國第一部醫學知識的匯編，也是中醫經典的開始。比如在第二章中，建議夏季“要心情舒暢，無怨氣，氣才能暢通，内外相通。這樣，秋天就可以避免疾病”（Ni，1995，第5頁）。此外，在同一章的後面，它指出“正如秋天的天氣變得嚴酷一樣，情緒也可能變得負面。因此，保持冷静、平和，避免抑鬱，這樣才能順利過渡到冬季。此外，還應避免吸煙和悲傷（肺所主的情緒）。這將防止冬季出現腎臟或消化問題”（Ni，1995，第 6 頁）。這兩段話清楚地表明，從中醫的角度來看，積極的情緒有助於保持健康，而消極的情緒則容易導致疾病。這種醫學中的哲學不僅看到了情緒與健康之間的聯繫，而且還看到了健康與季節之間的聯繫，表明某些情緒更適合某些季節。令人驚訝的是，盡管這些概念是中國人在幾千年前提出的，但現代研究實際上似乎支持這些概念。劍橋大學研究人員進行的一項研究比較了英國和大洋洲的研究隊列，發現免疫細胞内發生基因變化以應對季節和氣候（Dopico et al., 2015）。這表明我們的自然免疫力確實會對季節的變化做出反應，確保我們的身體做好最好的準備來扺禦一年中某個時間可能比另一個時間更普遍的疾病。《黄帝内經》第十三章也指出，歷史上人們的生活方式是“情志平和，無過多的欲望……保持精神内守”，以及思想和精神的集中，這阻止了病原體的入侵”（Ni，1995，第 50 頁）。在這裡，我們再次看到積極情緒和心理穩定具有促進健康和預防疾病的作用，而且這些想法似乎也得到了支持。一項隨機對照試驗的系統回顧研究了冥想和正念作爲治療工具的功效，事實上，發現了一些證據表明這些做法與免疫系統活動的某些生物標誌物的變化有關，并且可能對健康産生積極影響（Black & Slavich ，2016）。

與支持情緒與健康之間聯繫的大量科學文獻相反，可靠的同行評審來源提供了相反的證據，情况似乎恰恰相反。然而，盡管總體上缺乏學術文獻，一項題爲“接受消極情緒和想法的心理健康益處：實驗室、日記和縱向證據”的研究確實爲相反的觀點提供了至少一些支持。總的來説，研究發現，那些接受自己的消極想法和情緒，而不是評判或試圖避免它們的人，從長遠來看可能會享有更好的心理健康。同樣，有證據表明，練習接受負面想法和情緒的人實際上可能會减少經歷這些負面想法和情緒。最後，研究發現，與没有練習接受的參與者相比，練習接受的研究參與者對壓力情况的反應方式不會加劇與壓力源相關的負面想法或情緒（Ford et al., 2017）。所有這些發現都表明與中醫關於健康與情緒之間關係的觀點恰恰相反。然而，在中醫看來，經歷壓力會導致肝氣鬱結和與之相關的負面症狀，悲傷和悲傷會導致肺氣虚的症狀，上述研究支持的觀點是，經歷這些情緒，事實上，實際上會提高整體健康水平。

盡管有證據支持和反對中醫關於情緒及其對健康和福祉的影響的理論，但支持每種觀點的證據數量之間存在巨大差异。爲此，很難得出任何其他結論，只能説古代中國人已經能够認識到健康與情緒之間的聯繫及其重要性，比西方對抗療法醫學開始懷疑是否存在這樣的聯繫要早上幾千年。即使没有任何支持性的科學文獻，最終，也許證明這種聯繫存在的最佳指標是大量可以追溯到古代的從業者病例報告，以及許多世紀的患者經驗，表明這種聯繫確實存在。

作者簡介：

杰弗裡·麥基恩 (Jeffrey T. McKean ) 2023年畢業於美國馬薩諸塞州藥學與健康科學學院新英格蘭針灸學院， (NESA) ，獲得針灸和中草藥碩士學位。他之前在伯克利音樂學院獲得了歌曲創作音樂學士學位，輔修戲劇。 目前是 NESA 針灸博士候選人。

楊冰 中醫師，九十年代畢業於北京中醫藥大學， 獲中醫學學士、碩士學位，後於美國麻省藥科與健康科學大學獲博士學位。現為麻省藥科與健康科學大學新英格蘭中醫學院教授，中醫系主任，並在波士頓行醫。參考文獻

參考文獻

Black, D.S. 和 Slavich, G.M. (2016)。正念冥想和免疫系统：随机对照试验的系统评价。纽约科学院年鉴，1373(1)，1324。 https://doi.org/10.1111/nyas.12998

Dopico, X.C.、Evangelou, M.、Ferreira, R.C.、Guo, H.、Pekalski, M. L.、Smyth, D. J.、Cooper, N.、Burren, O. S.、Fulford, A. J.、Hennig, B. J.、Prentice, A. M.、Ziegler, Anette G.、Bonifacio, E.、Wallace, C. 和 Todd, J. A. (2015)。广泛的季节性基因表达揭示了人类免疫力和生理学的年度差异。自然通讯，6(1), 7000。 https://doi.org/10.1038/ncomms8000

Ford, B. Q.、Lam, P.、John, O. P. 和 Mauss, I. B. (2018)。接受负面情绪和想法对心理健康的好处：实验室、日记和纵向证据。人格与社会心理学杂志，115(6), 10751092。 https://doi.org/10.1037/pspp0000157

倪茂盛. （1995）。 《黄帝内经：新译》 《内经素问》附注。香巴拉。