Acupuncture forPsychological Problems

Key words

lntrcductionTwo cornmon psychological problems which areoften secn by the general practi t ioner respond wellto acupunctufe excepL in severe cases.1. rcactional anxiety2. reactional depression

These two pfoblerns may occut even Ln paltenlswho are "healthy" frorn a psychological poinl ofview, as a reaction to a variety of traumatic eventsoccLrrr ing to the patienit, one of his family, or a closefriend, such as:

death ot naior illness;family conflict or divorce;prcblens al vlork;roao accldenL;an ageressive or vialent ad, elc.

When one of these events is part icularly traurnatic,ot when many lraumas succeed each other over anumber of monlhs or even years, the nervous systemof Lhe patient may become "t ired" and "decompen-

sate", so thal lhe patient becomes anxious anddepressed.

f he T rad ition al apprc ac hIn Trndlt ional acupuncture, the treatment oI psychological problems is very complicaled, tke mostTladit ional treatr.ents.ln most books abolr l nadit ional acupunclLtre, the

authors, who tend lo replicate each other s ei lorts,make subtle dist incl ions between the supposedaction of this and that point. This att i tudecomplicates teaching and part y explains whyhundreds of hours ol teaching are necessaly to leafnTradit ional acupuncture-ln the book of Lebarbier ( in French) you can read

fot example:sp/een 2i this st imulaLes the intel l iSence ofchildren, awakes their interest for sludyinS,facl l i tates the comprehension of rnathemalica,a rd np r " r , . l . - - h ' r l \ l . _ . mo l i ' - [ , , 1 . .Heari 9i this is a very irnportant point for thepsyche (apprehension, lremb inB, sad thouShls).llis "un paint securisant".

Pericardium 9: this combats lack of energy in apatienl who is anxious.Triple enargiser 3:Ihts helps in a depressive slale,sadness and lack of confidence.

In fact, al l these descript ions are of symptcrnrs oidepressive tendencics. You can be sure thai i lacupLrncture helps a chi ld to stud), better a8ain, i t isthanks to i ls posit ive action a:lainst anxiety ando , p ' t s \ . i . r . r o b " , - u . . ' r r p L n l r a n l i r o \ 4 .intel lectual abi l i i ies.Instead of gi! ing a hundred descript ions of

depressive syrrploms, al l trcated specif ical ly by onepoint or another, the lradit ionalists should say: "Use

a combination ol these points for a sprtd, sitnpletreatment of deptesslon". I am sure that there isl i t t le, i f any, real difference in anli depressivc actionbetween one point and anolher. The sinplicity oithe treatments I shal advise wi I perhaps surpriseyou. Yet i t is with these very sinrple lrealments that Ihave been successful ly treal inB my palients for morethan 15 yearsl

THE IREATMENT OF PSYCHOLOGICALPROBLEMS

1. The trcatment of rcactional anxiet,The fol)owing classica poinls can Lle useclbilaterally (not of course Governirs ot Conc-opliotlVesJe4:Conception ycsse/ lr2 and 15, Stotliit(h 36, Latge

lntestine 1, Livcr 3, and Coveming Vessel 20.Coverning Vessel 20 is a very poweriul poirrt

which should not be Lrsed if you suspecl Lhe palie| l lof being depressed.A sirnpler treatnrcnt is to use points situated

between lhe xiphistcrnunr and the pubis - you rlonot have lo be very careful about the l)recise locrl i-sation of lhese points. Also, in some cases where thepatienl complains of a sensation of oppression in lhechest, you wil l l ind lender points on pa pation ol thesternum. Insert a needle wherc i l is tender unti l i tmakes gente conlact wilh thc stemunr. ln myopinion the only lhinB \,vhich is important is tostlmulate differenl nervc Toots and to give them arJn L i r r t . r -o r l a f l i u l i o1 h i ' r r . -cither a good number oi needlcs (aboLrt ninc shouldbc adequate), or a smal ef number oi fecdlcs wiihmore rnanipulation - which rnay be more painfu, soIdo no t no rma l l y ac l v i se need l - " man ipL r la l i on .

s0

Anxiety, Deptession, Traditional

on 5 July 2018 by guest. Protected by copyright.

http://aim.bm

j.com/

Acupunct M

ed: first published as 10.1136/aim.9.2.80 on 1 January 1991. D

ownloaded from

of course you can use points from both theclassical and the simple treatments I have advised,but the jmportant point is to limit yourself to about 9needles in total.

A certain number of your patients may be sensitiveto caffeine. Ask how much coffee, tea or cola theydrink. Note that the sensitivity to caffeine maybecome greater with age.

2. The '/eatment of reactional depressionThe classical points which I recommend are advisedby Dr Lecomte of Binche, Belgium. The differencebetween his approach and mine is that ldo notmerely choose a few only of the points he advises(taking into consideration old, TraditionalAcupuncture rules). I use all of theml The pointsshould be used bilaterally:Heart 9, Peticardium 9, Small lntestine 3, Triple

Energiset 3, Gall Bladdet 41, and Spleen 2.Some of these points are also advised by Lebarbier.

The simpler, non-classical, treatment uses '12

needles inserted in points both easy to rememberand easy to use. Put the needles on both sides of theroot of the nails of the last three fingers of bothhands as shown in Figute | .This treatment includes Hearl 9 and Pericardium 9.

It includes also 2 other acupuncture pointsconsidered as having no therapeutic effect on thepsyche: Smal/ lntestine 1 and T ple Eneryiser l.The 2 last points are not registered as acupuncturepoints.lf you use this kind of treatment but do not want to

make your patients believe that you know only afew points, you may use equivalent points on theother two digits. Although I believe that all thepoints situated on the extremities have the samekind of effect, I am more sure of the effectiveness of

fiaurc. l. Tnditional and sinple points on the hand forreactional deprcssion

those on the 3rd and 4th and 5th digits. Itherefore advise chanSinS the fin8ers used onlythe f'rst treatment. Again you can use a combinationof points from the classical and simple treatments,but use between 1O and 12 needles only.

PRACTICAL ASPECTS OF TREATMENT

1. Choice of the treatmentYou have to choose between the treatment directedagainst anxiety and the treatment directed againstdepression. However, you should of course bear inmind other organic causes of anxiety and depressionsuch as thyroid disease or a brain tumour that mayrequire conventional intervention.

a) You choose the treatment against anxiety:After the first treatment bring the patient back a fewdays later, if he is befter, just continue the sametreatment. However, if the patient has becomedepressed, use the treatment against depression -this will most probably be the only treatment thepatient will need over the following months oryears. From time to time, depression may follow notthe first treatment but a subsequent one, in whichcase you should follow the same rule of treating thepatient in future for depression, although you mayoacasionally use needles against anxiety again inlater treatments. lf the patient is not better at all afterthe first session, you may try the anti-depressivetreatment.

bt You choose the treatmenl againsl dcprersion:A{ter the first treatment, brin8 the patient back a fewdays later. lf he is better, just continue the sametreatment. lf the patient is not improved, he willmost probably not be helped by acupuncture. Hisdepression may not be a reactional one but mayinstead be purely neurotic, bipolar, or due to anorganic cause.

Remember that the depression which may follow atraumatic event, Iike the death of a member of thefamily, may appear a few months or even 1 or 2years after the traumatic event happened. Youhave to explain this to your patient who is generalunaware of Ihis "rcktded depression". fhe patimay be totally happy at the time the depressbeSins. For example, a man whose wife died tyears ago, and who is now happily remarried,Bet depressed even if everything is OK.depressive mood may interfere seriously in hisrelationship. He may believe, Jor example, that ihis new wife who is responsible for his feelingiunhappiness.

2. The number of tteatmentsIf the treatment was well chosen, the patientbetter after the first treatment! lf not, hisbeing helped by acupuncture areNonetheless, the beginner should try one

81

st.3

vmore lrealments before stopping acupun

on 5 July 2018 by guest. Protected by copyright.

http://aim.bm

j.com/

Acupunct M

ed: first published as 10.1136/aim.9.2.80 on 1 January 1991. D

ownloaded from

the car ly stnges oi l realnrent, thc pat ient shoul. l bcleen t \ ! cc ' a \ feel( i f lhe prob cm s inlportn|r l . Al lc lthe i j rst t lvo $,eeks, Ll j -" pal icrt may genefal y bclrcalcd once a rveek, bul ai tcr a terv rrore l realnlcntson.c.r fortnight is sui i i . ienl . Ai tcr a certni |1 rr !nt l )croi sessiofs thc pat ient \ ' \ ' i l l l ind th.r t the benei i l he i \r-"cciving i rom voLrr l realmcrrt hrs stnbi l ize(1. Youc.1f thcn stop the l fenLnrcnl, but \ ro! (oul( l ad! iscyo!f p.r t ic.nt , especial y n scvcle cdses, lo col lcback oncr. r moflh, s inac a pat ient l )ecomes alvaralhat rc is depresse(l of ) , \ . -hcrr thc depresl lve mooclis a fcad,v quite sev-ore. YoLr prt ient rr l , ry loserrorths of his l f - . in need css depression, r ;hcrt alrc.r tmcnt done ever,v r)rorr lh woulcl prevet i t .1n\ 'rcappcrrrnce oi d-opr-ossivc lcc ings.

l r e n e e d l - . s a r e l e i t i n p l a c c ' i o r 2 0 n r i f u t c s i n a l ltha trcatments,

In nly pract ice r1 edsl, l l re kind oi t renlnrerr l | !scnost frcqLrent l ,v is lhnl dlrcctcd .r ! ,1i | ] ls l . lepressionr a r h c f t h a n n g n i n s t i f x i e L y . I t h l f k t h n t i l w i l b c t h csanrc Ior tha' reader.

most distal oc.r t ions l )ossible, 5ince the sk n oi thccxtrcmit ies has a rruch greater conce| l l ral ion oircceptors th.rn in other parLs of the bo(lv.As do noL l)e i -"v-" I lhe exislence ol nrer idiar]s, i1

\ \ 'as Jn e!rsy slep ior nre lo l ry usin! i 1h,o\e nrostd stal points on Lhe i ingerr. | lo$i i in( l Lh.r l mvfesults have proved 1o be.rs gooal or elen bet ler\ \ , h i e r s i n g l h i \ \ i m p c r t r c a l m c n l .

lnforrnafion on IruiningDetni ls oi nrr lef ial i f lh s p.rpcr, and nany othcfsubjects, \ \ , lbe di<cr iscd .r l coL]|scs hcld cvcryNovember in I l fLrsscls, orgar sed by thL' , rst l i r / lcl'ens--ie,nent-.111 cle l'acuputlcture et dcsraf lexoth-; tapies. These Jivc day courses, at wh ch a!,nr etv oi eclurcrs spcak incl !c l i | lg Dr Fe ix N.1.rnnof the l lMAS, are i r tcndcd to be comp etelysLf i c ienl to l r .nsiorm a dociof total y igfcrrrnt oiacrfrundufe i f lo a vcry good pract t ioner.The bas t : pr inc plc r .-hich gu dcs our tench ng s

thc' lotr nbi f . lofmenl oi t l rc art ique concc'pts oil la l . l i t ion, i l A.upLrnclurc (r \ lcr idians, v ir r ; lD!, Fi ! ,ee . 'nrenls, ek l . Abarrdo1l rg thcse annchronist icthcoric.s i r i o$,s Lrs lo or l lani ic .1 \ ,cry short cou se,total v rnt ionr l , . rn. l mlrch casic tcr undc'rstand thrnl rc Trndit iof ,r . rpproach to acuprfctu ( .Conccrning lhe l turalnrcnl ol psycholo!, icapfoblems, thi5 .rpproa.h h. ls lhc advaftage ol

B! iding us to a ver\ , l ) fnBrr,r1i . afd sir .plc trcatmcft .

ConclusionThis fcw approach n lows Lr\ 1() fal ion.r l se andsimpl l f -v the l )rn(: t l ( :e oi . l .Lrpuncturc. lheabanclon ng oi t l re old conccpts of Tradit ionna c u p u n c t u r e i s . r l s o . 1 \ , e r v l m p o f i a n t s t e p t o w n r c l sbcl tcr acceptnn(e oi eaupLrrrdLLrc I ihe medic.r l

advise

3. Ihe side effects ol lrcatmcntThe patcnt nrav become morc nctvcrLrs iorhours, gcnera ly on the day ol thc tre.rtmenl.

\ . . r . , , * ) r ^ . L . i , . .

pa l i cn l s on the da i ,o i l r ea t r r cn t , so . r l \ \ , nyslolrf pal icnts to drive ver), cafciul -v ior thei lre da,v, cvcn f t rey clon' l iee s ccpy.

L Advantages of acupuntlurcA(:LrpufclLrrc nra-v n,el be 1l)-" oir ,v trcatmenl lh.rLcalr he p yoLr pate| l t . Thi \ is oi course n LireatadVanlagc. Other nclv.r)Lages arc:

iIt i rntncdi.1tc response :In.k oi .ontta indicat ion\;no r€dl s idc ct ie(ts;n() (1r11!: OCpCDOen( P.

5. Olher indications for lhe treat''ent agatnst

Ac ! l )Un ( tu re l r ca tn ren l ngn ins l dep rcss on canhepiu ir thc Io lorving groups ol patients ,rsnnslens le(1)vcTV:

t l )e rery sic l i or del) i l i la le(1;l)osl opcrati\le:iollctvLin2; a nyocar tl i al inilt al ion ;

Also I aan hc p canr:erp o b l e l s . l f g c n c r a t h i sdepr-"ssion, givcs p.r t e| ] l lsbeconre I iL aBain ancl to conrb.rL discase. This ispart iculnr -v evidefl rvhcn used fol o\ 'r , ing a stroke.

6. Why have I changecl itutn lhc TraditionaltreatmenllI had noli .e. l ihat my nee(l les \.-erc ocatecl moredistal y \._hen I trcatecl depressiorr ihan whilel r ca l i ng n | l x i e l - v . So Jas<ed m l , se l i i i l he i n rpo r tnn tI.rctcrr i | l Lre,rLlfg dcpresso|1 nl iBlr l l)c to use the

Dr S Faust211 ,1v- Huysndns. Bte I

1050 Brussels, Eelsium

I I c l r . rb ie r A l l t l i l l L ' ,1 . !p ! r .11 t r . / rnnqu. l j i n r r ie (^e ,i r

p a l i - . f l s l o d c a l w i l h l h e i rl fenlmefl , bv rcl ievlng Lhe

nlore eferty to exera: ise,

E2

Pl,y^rturarcArc you even nrore nrrxious lhan yoLr patie.ts?

Are you permanentlv t rcd, Lrnable lo concentrate ormakc d.. ls i . ' rs? | am!

I dof'1 need acupunctur€ b so( oul my ji-.. You cando i! ior mc by scnding your .lfticles ior lhls Joullralproperly ryped, in iaulr lcss prore and Iul ly contofminB1.r tho 8!idclines you \rlll find in "lnslructiorrs forAuthors". lhen .cturn your proois pfomptly ancl nrakeno late changes Lr the tcxlL

Thank vou

tdrtor

on 5 July 2018 by guest. Protected by copyright.

http://aim.bm

j.com/

Acupunct M

ed: first published as 10.1136/aim.9.2.80 on 1 January 1991. D

ownloaded from