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Shen Management

By Lillian Bridges

Most of the focus of Chinese medicine in modern times has been to treat disease. And although acupuncturists are much better at preventative medicine than most Western physicians, there is an aspect of prevention and treatment that is often overlooked -- Shen Management. The Neijing states, "Overindulgence in the five emotions - happiness, anger, sadness, worry or fear, and fright - can create imbalances. Emotions can injure the qi... Failing to regulate one's emotions can be likened to summer and winter failing to regulate each other, threatening life itself."

In the past, it was quite common for people to repress their emotions. This was part of the social norm. According to the principles of Chinese medicine, this under use or overregulation of emotions also contributed to many diseases and illnesses. Perhaps this is one of the reasons that psychotherapy became such an important profession in the Western world. It was necessary and helpful for people to uncover long buried traumas and hurts. Numerous treatments were developed to help people learn to express themselves. As psychology became more mainstream, it was believed that people seeking psychological health needed to learn to express themselves.

There is no question that freedom of expression is a valuable thing and that releasing emotions is healthy. Unfortunately, much of the quality of expression has intensified so that the pendulum has swung in the opposite direction. There is now an outpouring of emotion that can be seen on a daily basis. It is quite common for people in severe grief to be shown on television sobbing and wailing at the loss of a loved one. This emotion was once expressed only in private situations. The deeply personal has become a public spectacle. Anger is currently one of the most socially acceptable emotions, and is seen and expressed in numerous ways even directed at strangers who happen to be in the way. Parents worry so much about their children's safety that an entire industry has been created to childproof home environments. Excessive excitement artificially generated by reality television contests, game shows and talk shows create frenzy in the viewers. And recent catastrophes both manmade and geological are of a magnitude not seen in generations, unleashing tremendous amounts of fear around the world.

Emotions are both necessary and even helpful to living, except when overused, but the Ancients cautioned heavily against overindulgence in the five emotions. Although extreme expression is temporarily cathartic, if continued, it ultimately leads to diseases of jing and qi deficiency that shortens the lifespan. It helps create chronic and debilitating illnesses that are occurring at younger and younger ages, and also encourages accidents and injuries. Practitioners can monitor excessive use or under use of emotions by evaluating the Shen of their patients' eyes and facial coloration.

Deficient qi is seen as a dullness or shallowness of light in the eyes. If the Shen of the eyes is murky, the patient is in the midst of emotional turmoil. In contrast, someone who is healthy and vital shows signs of strong qi, which is seen as a light brightness or glow in the eyes. One of the most confusing aspects about Shen is how temporary it is and how easily it fluctuates. Shen is activated by the autonomic nervous system and is impossible to conceal except by covering the eyes. Chronic Shen disturbance indicates mental imbalance or mental illness. If the eyes are consistently very dull, this is an indication of repressed brain activity, which includes severe depression or illness that creates anhedonia. If however, the light of the eyes is too bright, this could indicate fever if temporary. If this excessive brightness continues for any length of time, it is a clear sign of mania. Continuous confusion in the eyes can be a sign of mental deficiency and is symptom in a disease like Alzheimer's. Craftiness is a sign of paranoia and a glazed look is a sign of substance abuse or when severe, indicates psychosis.

But most Shen changes are rapid, and for practitioners it is advantageous to learn how to read even momentary changes in the eyes that indicate flashes of emotion. Recognizing these changes can help guide the course of conversations and help determine treatments. Fear shows as a sudden startle response, and then a rapid lowering of qi so that the Shen gets muddled. Anger is seen as an intense focusing of qi in the eyes and creates hardness in the Shen. Excitement at first creates an attractive sparkle, but this light is transitory and soon fizzles. It is easily seen as scattered qi. Worry causes the Shen to vibrate and even the eyeballs themselves will either move back and forth, up and down or around and is often accompanied by a similar head movement. Grief causes the qi to dissipate and there is a lifelessness and darkness to the Shen. When an emotion is felt for any length of time it will be held in the body - not just in the organ responsible for its' transmission, but also in whatever organs are weakest. Then, it shows on the face as skin coloration.

Lustrous colors of the face indicate that a patient is healthy. Any of the five element colors is acceptable as long as it appears as if the color has been wrapped in white cloth meaning it has lightness on top. For example, the most beautiful skin color is described as white cloth covering cinnabar. Another ancient analogy of healthy skin color is when it has the appearance of a ripe peach. But when a patient is unhealthy, the various colors show up on specific parts of the face indicating the organ involved. The five basic colors show whether a certain organ has been compromised by overuse or underuse physically and/or emotionally. Stagnation is seen as darkness, inflammation is redness, frozen or immobilized qi shows up as whiteness, toxicity is green and putrification is a yellow or sallow coloration. These colors, of course, can be seen in combination. When the color covers the entire face, the illness is considered very deep and dangerous.

The increasing amount of disease and illness already occurring and potentially threatened reveals the need for more even more prevention. Renewing the practice of Shen Management is therefore wise. This means that individuals need to take responsibility for their emotions and learn to regulate their expression in appropriate and moderate ways. Although certain times and circumstances in life require expression, other times require observation and contemplation. One of the most valuable techniques that can be practiced is "Compassionate Detachment". By feeling compassion, you remain involved but do not take on other's suffering as your own. You remove yourself slightly if it is not about you and yet still care. However, the desperate and pervasive need for attention is fueling the emotional drama. People claim they want peace, but peace is not possible as long as emotions are flaring.

For health practitioners, you owe it to your patients to manage your own Shen and teach this ability. Work on your issues and clear your mind. Healing can be amplified when you come from a place of inner quietude and love. The quality of Shen that appears from this state of being is beautifully soft and translucent like clear pools of water. The eyes glow with the light of an illuminated mind. As Chinese Medicine has always been concerned with balance, managing Shen is one way to achieve some much-needed equilibrium in our increasingly chaotic world.

Ni, Maoshing Ph.D. The Yellow Emperor's Classic of Medicine, Shambhala, Boston 1995, pg. 19