Diagnosing Heart-Sickness

by Felice Dunas, Ph.D.

Sonya fell in love again. She is in her late 30s and her body clock is ticking so loudly she mistakes the sound for tinnitus. While she hopes that this relationship will be the one to work out, it is doomed from the start just like the last several romances she has pushed herself to have in the name of finding the “right one.” Sonya is frightened. If she blows this opportunity, it will be another feather in the cap of failure for her. Her self-esteem will be even lower as a result. If she figures out how to do this one right, she just might have a chance at the future she wants. Her life could finally contradict the loneliness that motivates her to overfill her days with work... No pressure in that scenario!

But Sonya came to you because she has menstrual problems. Cramps while bleeding, headaches while ovulating. You work diligently, taking a full history and treating the energetic syndromes that are a sure bet etiologically. While you are tireless in your efforts, Sonya continues to pour energy into her fledgling relationship. It is harder for her to handle the romantic situation that you do not even know about. She is struggling through the thick goo of energetic phlegm and emotional stagnation. Being a vegetarian with a soggy spleen makes it hard for her body to metabolize all the loving that is coming to her. She does not see his affection clearly. Her inability to integrate new information or to process old data differently will make it impossible for her to believe her new lover is unique from all the others. Ultimately his behavior will become less unique as her patterns force him to reflect what she believes is true. The soft sound of his voice will sharpen into harsh accusations. He may wonder what has caused him to behave so poorly and will not like hearing who she perceives him to be. She will miss the man she has begun to love because he has changed so.

Sonya’s organs are working to maintain equilibrium while confronted with the emotional highs and lows of her new affair. Joyous beyond joyous, her heart feels full to overflowing. As a result, she cannot sleep. The heart’s child organ on the five element shen cycle is the spleen. It is getting some much-needed juice by all of this. But as it becomes over-stimulated, Sonya loses her appetite for anything other than her man. She can’t think straight and loses a few pounds. Not that she minds, of course. Her liver is processing all the chemicals that rush into the bloodstream as a result of new love. Sonya’s endocrine system is producing hormones specific to the first few months of romance, and endorphins alter her mental state. Her kidneys, adjusting to changes in control by the spleen and having no luck regulating the heart at this point, are urging her to be sexual. The lungs, the child organ to the spleen on the shen cycle and controller of the liver on the ko cycle, are utilizing the chi flooding into the spleen by the heart. Lungs transform this into the bonding ability, the intimacy factor. And when it all ends, the lungs mourn, the heart breaks, the liver is forced to contend with the wild fluctuations of emotion and control from both the kidneys and lungs on the five element ko cycle. Hormone levels shift, sexual play vanishes and the kidneys generate fear that no new love will ever come into her life. Sonya’s skin aches for her lover’s touch. With chronic dampness in her system, how can any of his heal quickly? The swamp of pain will be larger or smaller depending upon the season of Sonya’s life and the season of the year. But there is a swamp to be trudged through nonetheless.

You see patients like Sonya frequently. Though you may never hear about this side of her life, or at least the underlying patterns associated with it, she needs your support here just as she needs her menses regulated or her headaches alleviated. The complexity of her symptoms and syndrome profile include her underlying psychological pressures and the poor relationship skills that leave her life riddled with pain and longing. When her body is flooded with new chemicals as a result of her affair, you may not even know it. While you may see some changes on the tongue or fullness in the pulse, it takes careful questioning of all aspects of the patient to discern the control of love or lack thereof.

I am not suggesting that you become a psychologist, though good training in TCM does introduce you to theories that expose patterns of emotional expression. Our professional ancestors discovered a relationship between psychology, cognitive function and physiology that appears simplistic on face value but interprets awareness or facets of consciousness brilliantly. Consider viewing a patient’s life experiences as important factors diagnostically. Rather than utilizing other paradigms, such as those based upon contemporary psychology, integrate what you already know about TCM interpretations of the workings of the mind and emotions.

One of my key diagnostic questions is: “Which emotion do you spend the most time in?” Obviously this sends you in the direction of a specific internal organ if you work with zang fu or five element theory. But the question sets the stage for a discussion of emotions as symptoms. Patients need to know that their perception of themselves and their attitudes may be symptomatic. While most people believe that they have a body, they also believe that they are their mind and emotions. Ego feels like who we are. Personality feels like self. And with the guilt and shame of everything stemming from these dysfunctional childhoods, the weight of the self seems almost immovable.

By the way, have you met any one who did not have one of those miserable upbringings? If Sonya understood that her repetitive relationship cycle could be traced to syndromes rather than self-hatred, she would not only be relieved, she could better participate in her own healing. If you know Sonya as an integrated whole — her body’s patterns, her romantic patterns, her overwork patterns, her emotional patterns — your diagnosis and treatment protocols only increase in effectiveness.