An important part of the service we offer at the Sean Barkes Clinic is helping people understand why they are not well. As therapists, we need to understand why someone has back pain, or irritable bowel syndrome, or insomnia, so that we can treat them effectively. Because, after all, it is no good getting rid of someone’s symptoms if the cause of those symptoms remains – the symptoms will simply return. So through discussion with the patient, especially at their first visit when we do a detailed consultation and health assessment, we aim to discover what it causing the problem. Sometimes of course this is fairly obvious – if someone smokes thirty cigarettes a day, it is no surprise if they have a hacking cough – but often the picture is more complex than this, and there is quite a bit of detective work in understanding what is called the aetiology of the problem, what has caused it And quite often there are a number of contributing factors which have given rise to the problem. These factors will include some of the following kinds of causes:
1. Emotions
Although in the Western world we tend, for historical reasons, to think that the mind and the body are separate, it should really be no surprise to anyone that emotions can affect our body and it’s functioning. People who are nervous get ‘butterflies’ in their stomach, or perhaps find themselves going to the loo a little more often; people who are scared may find their heart beating faster, or that they are breaking out into a sweat. The mind and emotions on the one hand, and the body on the other, are intimately related. Whilst the occasional bout of nervousness is not going to do anyone any harm, if we get ‘stuck’ in a negative emotion over a long period of time, so that it becomes habitual, we will probably get ill.
For example, Chinese Medicine makes a connection between grief and sadness and the lungs. If we spend our life grieving over something that happened in the past, and do not move on from it, so that we are in a constant state of sadness, our lungs will eventually be affected; perhaps our breathing will become too shallow, or we develop a recurrent tickly cough; eventually perhaps we end up having asthma attacks. These may be controlled by pharmaceutical medications, but the underlying lung deficiency remains. To treat the asthma, cough and shortness of breath fully, it will be necessary to find a way of moving on from the sadness and grief.
2. Food
As well as emotions, another thing that affects us on a daily basis is, of course, food. Most people have at least some awareness of the importance of eating a healthy diet, but it needs to be remembered that what may be healthy for one person may not be so for someone else. For example, a diet high in raw, cold food might be a good thing for someone with a strong digestive system and a propensity to overheat, but for someone else who tends to feel the cold easily and has a tendency to pass loose stools, what is needed is warm, well-cooked food which is easy to digest. One of the advantages of Traditional Chinese Medicine is that, once a diagnosis is made, dietary advice which is specific for the individual concerned can be given, so that the food we eat helps us become more, rather than less, healthy.
3. Climate
Many people notice that their symptoms vary with changing weather conditions. For example, one person may notice that their knee pain is worse when it is cold and damp outside, whereas someone else may find that their asthma bothers them when it is windy. In contrast to modern times, when many people spend most of their time cocooned from the weather, Chinese Medicine arose in a predominantly agricultural society in which changes in the weather and their effects on human physiology could be closely observed and understood. Thus Chinese Medicine has a developed understanding of how climatic factors can undermine our health. An example of this is the Chinese Medical concept of Dampness; this refers to a failure to metabolise body fluids properly, leading to such symptoms as oedema, a heavy head, loose stools, bloating and weight gain. Whilst some people are constitutionally prone to Dampness or may make themselves so prone by eating inappropriately, living in a damp climate such as is found in the UK may also lead to Dampness accumulating in the body. We could say that our internal climate is influenced by the climate outside.
As mentioned above, whilst this is a very real issue for people who spend a lot of time outdoors whatever the weather (all the more so if they fail to dress appropriately), even those who do not may be affected by the artificial environments of air-conditioned or centrally heated buildings. In contrast to the damp outdoors, these environments may lead to excess dryness in the body. Furthermore, we may not as insulated from the outside environment as we may think – it is easy to get a stiff neck from being exposed to a cold draft for instance.
4. External Pathogenic Factors
This traditional Chinese medical concept is roughly analogous to the western understanding of bacteria, viruses and other bugs. The Chinese concept is of an external form of Qi which invades the body and disturbs its harmony, causing illness, usually suddenly. This pathogen may be related to the previous type of cause; living in a damp house may lead to a Damp pathogen invading the body.
However, such a pathogen can only succeed in causing illness if it overcomes the body’s defences, which in Chinese Medicine are represented by the Wei Qi, – the Defensive or anti-pathogenic Qi. This is again somewhat analogous to the western idea of the immune system. The stronger our Defensive Qi, the less likely we are to get ill in this way; if we fall ill quite often, perhaps catching every cold going, it is likely that our Defensive Qi has become depleted.
This traditional Chinese idea probably needs updating to include more modern ‘pathogens’, such as environmental pollutants and harmful forms of electro-magnetic radiation. For example, there is some evidence to suggest that part of the reason for falling sperm counts in western men is attributable to various toxic chemicals which are finding their way into our body’s, for example from traffic exhaust fumes.
5. Our constitution
Another factor in our susceptibility to illness is our inherited constitution, which in Chinese medicine is dependent on the health of the parents in general, and their state of health at the time of conception in particular. Whilst there is nothing we can do about it if we are born with a weak constitution, or one that makes us susceptible to certain kinds of illness, nevertheless we can live our life in a way which minimises the effect this has on us – even if we have been dealt a poor hand, if we play our cards well we can end up doing better than someone else who has a good hand, but squanders it.
What this means in practice is that if we have a constitution which is weak in some way, we will have to be more careful in how we manage our energy. Whilst someone with a robust constitution can ‘get away with’ burning the candle at both ends, at least for a while, we may have to realise that if our constitution is not so robust, we will have more need of proper rest and recuperation time. So staying well and healthy involves having a clear awareness of what our constitution is like, and managing our energy accordingly.
6. Lifestyle
This naturally leads on to the question of lifestyle. Broadly speaking, this comes down to finding a way of living that balances what in Chinese thought is referred to as Yin and Yang. In this context, Yang may be taken as referring to activity, energy which is expressed outwardly; Yin is to do with nourishment and a more reflective and inward-turned energy. Many people nowadays push themselves beyond their natural limits – working long hours, perhaps without taking time to eat and rest properly, always feeling the need to do, and to have (and to buy!) more. The kind of competitive consumer society many of us live in tends to encourage this way of life, but the result is that a bias towards the active Yang means that we burn up our resources of Yin – we burn ourselves out, almost literally. This may involve excessive work, excessive partying and sexual activity, excessive levels of exercise, even excessive thinking; often there is an addictive quality to our constant pushing ourselves beyond what is natural
Of course the strength of our constitution will determine how well we can cope with a time of imbalance, but even the strongest person will eventually suffer the consequences if their life is perpetually driven towards the extreme of Yang. The danger is exacerbated if we use artificial stimulants like caffeine and some recreational drugs to keep us going, thus switching off our body’s warning signs.
The flip side of this is another modern tendency, which is caricatured as the ‘couch potato’. Just as too much Yang activity is harmful, so a life of passivity and laziness is just as bad. This represents the extreme of Yin; in particular if our life does not include the right amount of exercise (and perhaps the right type of exercise), and the right amount of challenge and intellectual and emotional stimulation we will stagnate – our Qi stops flowing freely, we become stuck and bogged down, both physically and emotionally. Illness will inevitably follow.
A healthy lifestyle, then, is one that harmonises Yin and Yang; there are times of activity, exertion and challenge, and times of relaxation, reflection and quiet. Just as the night follows the day, and the seasons turn through the year, so we need to find our own rhythm. Of course the point of balance may change as we move through life; there is an art, therefore, in maintaining this balance as the years pass.
7. Iatrogenic causes
Sometimes the very thing which is supposed to be helping us avoid or overcome illness actually makes us ill – iatrogenesis means when illness is caused by medical treatment. One common example of this kind of thing is the side effects of many pharmaceutical drugs; quite often at the Sean Barkes Clinic we find ourselves treating patients for problems which are in all likelihood caused by the drugs they are on. Statins, for example, which are commonly prescribed to help lower cholesterol levels, can cause muscle problems; many painkillers cause constipation. Especially if they are using a drug long-term, patients need to be alive to the possible side-effects it may cause, and keep in touch with their prescribing doctor about these.
8. Posture
An obvious cause of many health problems, especially but not only muscular and joint problems, is poor posture. Again, rapidly changing modern lifestyles often involve us holding ourselves in positions alien to the way the human body has evolved. For example, the body is not really ‘designed’ for spending long hours typing away at a computer, or clicking repeatedly on a computer mouse. Whilst this is to some extent unavoidable, what is avoidable is unawareness. Almost the first principle of health is awareness of how we are holding our body and what it is doing. Thus if we have a tendency to hunch over a desk, with awareness we can work against this tendency, repeatedly straightening our posture as well as taking breaks to stretch our legs (and anything else that is tight!). As well as causing back ache, such a poor posture can have an adverse effect on the Qi of the Lungs, leading to similar problems as mentioned above in the case of chronic grief and sadness.
Conclusion
Often when we get ill we want to find a single cause that has made us ill, but the likelihood is that several of the factors mentioned above are involved. Whilst this might seem a little worrying, the fact is that all of the above factors can become ways in which we promote and maintain our health; for example, just as a poor diet can make us ill, so a diet full of nutritious food tailor made to balance our own tendencies to disharmony can make us better, and keep us better; just as sitting hunched over a desk can give us backache and asthma, so developing awareness of our body and holding it well can promote health and healing; just as a life spent at the extreme of Yin or of Yang will damage our deepest resources, so a life of harmony and balance will keep us well.
Destiny
One last thing to mention here is the Chinese concept of ‘destiny’. This does not refer to blind fate, but rather points to each person’s individual potential as a human being: our task in life is to fulfil our destiny, to become in a sense who we really are. When we are doing this we are likely to be well, our energy will be flowing freely, and in fact we may access energy that we never thought we had. If, on the other hand, our path through life is obstructed, perhaps by fear or anxiety or self-doubt, then our energy turns in on itself and illness may eventually follow. Destiny is about having a vision for who we might become, and striving to fulfil that vision. If we have lost that vision, our first task if we want to get and stay well may be to relocate it. Different people may do this in different ways: spiritual traditions, the arts, satisfyingly deep communication are some of these. Sometimes in fact illness itself is a message that we have lost that vision, and perhaps even at the same time it can be an opportunity to find it again, or to develop a new vision for the next phase of our existence.
