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Themes of qi and a dozen definitions

David Mayor, Marc S. Micozzi, in Energy Medicine East and West, 2011

Shamanism – some parallels and contrasts

The concept of 'vital energy' is shared by many ethnomedical healing and shamanic traditions (Ch. 7). There are notable parallels between qi and the 'something' that flows between the shaman and all living things, and as vitality through the shaman into the community [17], as well as between qi and the various vaporous 'souls' that only trained shamans can see (Ch. 3). 'Energy flows' are explicitly described in some shamanistic writing [129,130]. There are also parallels between acupuncture techniques and those of shamanic healing (e.g. mastery of fire/moxibustion, sucking/cupping, bleeding/needling). Indeed, one possible shamanic origin of acupuncture may even have been the hallucinations of piercing that can accompany the prickling sensations triggered in altered states of consciousness (ASCs) [131]. However, the importance of shamanism in Chinese culture may well have diminished (at least in official circles) by the time the Chinese medicine we know developed [32], and no contributors have paid more than passing attention to possible links and influences. Again, the topics of ecstasy, or even ASCs in general, are avoided.

This anomaly has an intriguing parallel in one US study, where ASC in Christian (Pentecostal or charismatic) healing groups frequently involved somesthesia (reports of tingling, warmth, buzzing in ears, or 'electric shocks'), whereas those in metaphysical (NA) healing groups were more likely to report feelings of harmony and calm [132]. (However, other authors have noted that feelings of calm, floating, or waves of love occur more frequently than heat or tingling in charismatic healing [133].) This difference is echoed in one analysis of bodily sensations in Tibetan dumo: feelings of warmth and relaxation may indicate greater parasympathetic (trophotropic) than sympathetic (ergotropic) activity, 'energy rushes' a state of 'hyper-trophotropic tuning with ergotropic eruption', and the contrary ('hyper-ergotropic tuning with trophotropic eruption' or rebound) a state of ecstasy or 'a generalized sense of flow' [43, p 126].

Indigenous shamanism often makes use of natural hallucinogens, as in the ayahuasca ceremony of the Amazon, or the peyote religion of the American Southwest [134]. Descriptions of drug-induced ASC not infrequently include words such as 'energy', 'current', vitality' [135], with feelings of melting and fluidity, shimmering electricity [136], tingling [137], oneness, or wavelike movements of the body [138].

It would seem that most of the energy medicine modalities described in this book are more concerned with parasympathetic than sympathetic activation, with 'de-tensionality' and 'attunement' [139], quite appropriately in our age of technological acceleration and autonomic overload. However, there is conflicting evidence on the autonomic effects of acupuncture (stimulation at one and the same point can exert both sympathetic and parasympathetic actions, for example, depending on depth of needling, stimulation intensity, and other factors). Given the importance of the goal of yinyang balance in Chinese medicine, and the frequent interpretation of this polarity in terms of autonomic balance, as for example in the Japanese ryodoraku () system [140], it would be most interesting to analyze a broader spectrum of interventions and methods in this manner.

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Physiology of Gua sha

Arya Nielsen PhD, Ted J. Kaptchuk MD, in Gua Sha (Second Edition), 2013

Anatomy of Qi

It is common to reduce East Asian's fundamental concept of Qi to 'Qi is energy', since energy seems to best describe the 'seemingly invisible transmission of effect'. Yet Qi is in fact substance as well as function, and the internal organs are not merely functional spheres of influence but substance influencing substance. In his introduction to The Nan Ching, Paul Unschuld (1986) agrees. He states:

The core Chinese concept of Ch'i bears no resemblance to the Western concept of 'energy' (regardless of whether the latter is borrowed from the physical sciences or from colloquial usage).

The Essentials of Chinese Acupuncture describes Qi as substance and function. In Celestial Lancets, Lu Gwei-djen and Needham (1980) translate Qi as matter–energy. Maciocia (1989) refers to Qi as material and non-material. Although many other English-language articles and texts on Chinese medicine talk of Qi as energy (Porket 1974, Mann 1977, Schatz et al. 1978), it is a departure from a basic understanding of Yin and Yang.

The material body is the vessel (Yin) that holds and by that holding, affords Qi function, or activity (Yang). Qi reduced to 'energy' eclipses its substantive form. This is consistent with a modern tendency to prefer 'doing' to 'being'. The Chinese character for Qi implies both its material and non-material nature, as seen in Table 3.1 (also see Figure 4.1).

Cou Li: lining

In Chinese anatomy, the Biao is the surface, skin and body hair. Just below the skin is the Cou Li, or Li: the lining that covers and lines the body, but is not the skin itself. Cou Li is also translated as pores: that function of the lining that allows entry and exit. The Cou Li, or lining, is where the 'three Qi steam' or where the channels lie, providing an ancient basis for the conductive physiology, attributed to connective tissue by some modern scientists. The Jinkui Yaolue Fanglun (1987) or Synopsis of Prescriptions of the Golden Chamber, first published in 220 ad, states:

In case pathogenic factors have invaded the Channels and Collaterals, medical treatment should be given in time to stop the transmission of pathogenic factors into the Viscera and Bowels. If there is heaviness and uneasiness in the extremities, daoyin, tui na, acupuncture and gaomo therapies should be practiced to clear the nine orifices … In this way, one can maintain good health and prevent the intrusion of pathogenetic factors through 'Cou li'.

The 'Li' will be discussed again in Chapter 4 as it relates to the San Jiao.

The Qi moves vertically in channels called Jing vessels. Jing vessels are the main rivers that 'pass through' (Epler 1980). Qi moves horizontally in channels called Lo vessels. Lo means 'to connect', here connecting the large vessels to one another and to deeper tissue and organs. Horizontal movement of Qi in the Lo vessels is refered to as the 'Path of Qi' (O'Connor and Bensky 1981) (see Figure 3.1). The pathways are themselves recognized as substantive and based in the body's 'Li' or lining; they are associated with aspects of the connective tissue network.

Path of Qi

As shown in Figure 3.1, the horizontal emanation via the Path of Qi delineates the three Jiaos. Points on the trunk of the body, the ventral Mu points and the dorsal Shu points, express disharmony and afford direct access to the Organs (see Figures 6.3 and 6.4Figure 6.3Figure 6.4). Disease in one part of the Path can be treated by manipulating points elsewhere in the same segment of the Path, including the extremities, head and limbs (O'Connor and Bensky 1981). The Path of Qi:

•

in the head indicates the relationship between the brain and face;

•

in the chest suggests a connection among the upper back, neck, chest and upper limbs;

•

in the abdomen relates the lumbar–sacral region, lower abdomen and lower limbs.

The Path of Qi accounts for the ability of surface techniques, like acupuncture and Gua sha, to directly affect the tissues and Internal Organs within a segment.

The vertical channels, Path of Qi (horizontal channels) and movement of Blood are the context for the penetration of the therapeutic effect of traditional East Asian medicine (TEAM). In past models of Western anatomy, the nervous system accounted for sensory perception at the body surface. However, it is not the nervous system alone that accounts for referred pain, what Ida Rolf (1977) calls 'congestion or malfunction of an internal organ felt as a limited spot of pain, sometimes quite intense under surface pressure, at a point very distant from the organ'. In TEAM it is the channels at the Cou Li, or lining, that mediate this phenomenon. Some modern theoretical models relate aspects of this mediation to connective tissue. For example, acupuncture's needle grasp, part of the 'de qi' response, results in visible 'tenting' that has been related to connective tissue response (Langevin et al. 2001a) (see Figure 3.2).

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Foreword and Special Contribution: The Living Matrix

James L. Oschman, in Energy Medicine East and West, 2011

Szent-Györgyi would celebrate the description of 'vital energy' (prana in India and qi in China) on page 3 of this book:

The ancient Chinese ideogram for qi () symbolized a cloudlike vapor, as when the breath is seen on a cold day.

Research in physics, quantum physics and materials sciences has provided an energetic picture of clouds of free, mobile, or delocalized electrons in living matter. These 'particles' are electrons that are not fixed in place, but rather belong to the whole system – they can give rise to holistic properties. By their nature, clouds of charged electrons are susceptible to external influences such as magnetism, heat, light, sound, vibration, electrical fields, pressure and so on. This observation is not to say that qi is identical with clouds of electrons. Instead of trying to make a definitive statement, we can say that clouds of electrons may be a partial representation of, or a partial correspondence to, one of the diverse forms of qi. Although such correspondences are interesting, they are certainly not essential to the wealth of diagnostic and treatment approaches found in Asian Medicine described in this book.

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Other Breathing Issues

Leon Chaitow, ... Christopher Gilbert, in Multidisciplinary Approaches to Breathing Pattern Disorders, 2002

The meaning of 'Qi'

The word 'Qi' which is usually translated into English as 'vital energy' actually has a wider meaning in TCM: 'TCM asserts that the body is possessed of Qi, which is at once its energy, life force, and material substance. Qi regulates bodily function and simultaneously is the body's activity as well as the material structures associated with it.' Early translations of the word Qi include: 'that which fills the body', 'that which means life,' 'breath,' 'vapours,' and 'wind' (Ryan & Shattuck 1994).

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Global Perspective

L.A. Mitscher, in Comprehensive Medicinal Chemistry II, 2007

1.09.12.2 Traditional Chinese Medicine

Traditional Chinese medicine is an ancient Chinese healthcare system based on the concept of balanced qi (a vital energy believed by practitioners to flow throughout the body that regulates a person's spiritual, emotional, mental, and physical balance). Qi is influenced by the opposing forces of yin (negative energy) and yang (positive energy). In this system disease is believed to result when the flow of qi is disrupted and yin and yang become unbalanced. Herbal and nutritional therapeutic interventions supplement physical exercises, meditation, acupuncture, and massage in restoring health. These concepts are not readily reconciled with the beliefs of modern medicine. The herbals that are employed are often complex mixtures of different plants added together to supplement each other's actions.

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Mitochondrial Biology and Medicine

Douglas C. Wallace, ... Vincent Procaccio, in Emery and Rimoin's Principles and Practice of Medical Genetics and Genomics (Seventh Edition), 2019

10.1 Introduction

Western medicine is organized around anatomy, yet life is the interplay between structure (anatomy), energy (vital force), and information. Consequently, the anatomical paradigm of Western medicine has largely overlooked the central role of bioenergetics in health and disease. This may be a critical factor in our inability to understand and develop effective therapies for the common metabolic and degenerative diseases and aging. While bioenergetics has been neglected by Western medicine, it is central to Eastern medicine with the concept of Qi, which can be loosely translated as "vital force."

The dichotomy between anatomy and energy for our cells harkens back to the origin of the eukaryotic cell about 2.5 billion years ago. In a unique single event, two co-equal micro-organisms formed a symbiosis that set the stage for all multicellular plants and animals. The original microorganisms were an archaebacterium that gave rise to the eukaryotic cell nucleus and cytosol and an oxidative eubacterium that gave rise to the cytoplasmic mitochondria. While the original archaebacterium and eubacterium had similar-size genomes, most of the eubacterial mitochondrial genes were transferred to the archaebacterial nuclear genome in association with the proliferation of the mitochondria within the cytoplasm. Because most of a bacterium's energy is used in replicating its DNA, transcribing its RNA, and translating its proteins, by transferring the mitochondrial genes into the nucleus, the number of gene copies for each gene could be reduced from hundreds to thousands down to two, with hundreds of -fold savings of energy. The excess mitochondrial energy could then be used to sustain a much larger nuclear genome with extra genes allocated for multicellularity and organogenesis.

By this process, the residual mitochondrial DNA (mtDNA) of multicellular animals and humans has been reduced to about 13 polypeptide genes plus the rRNA and tRNA genes for their translation on mitochondria-specific ribosomes. The mitochondrial ribosomes retain several features of bacterial translation including chloramphenicol and aminoglycoside antibiotic sensitivity and polypeptide initiation with a formyl-methionine. While few in number, the mtDNA polypeptide genes are essential components of the mitochondrial energy-generating process, oxidative phosphorylation (OXPHOS). In essence, the mtDNA codes for the wiring diagram of the cellular power plant while the nuclear DNA (nDNA) contains the blueprints for building the power plants.

Interest in mitochondrial medicine has been increasing rapidly during the past decade, with the current annual number of mitochondria-related biomedical papers exceeding that of genomics papers [1]. Furthermore, the massive efforts to sequence nDNAs to identify the common genetic variants that cause the common metabolic and degenerative disease have been disappointing. This suggests that the classic Mendelian paradigm of genetics is inadequate for a coherent understanding of human genetics. Many of the seemingly puzzling features of the genetics of common diseases such as variable penetrance, delayed onset and progressive course, and multiorgan involvement are naturally explained by mitochondrial genetics. Thus, by combining Mendelian genetics with mitochondrial genetics we can arrive at a synthetic paradigm that can explain many of the novel features of clinical genetics.

The first report that mitochondrial dysfunction could be associated with a clinical phenotype came with the report of a woman with hypermetabolism, abnormal muscle mitochondria (mitochondrial myopathy), and uncoupled mitochondrial OXPHOS [2]. Subsequent studies revealed a variety of clinical phenotypes associated with mitochondrial myopathy and OXPHOS dysfunction resulting in a proliferation of clinical descriptors such as chronic progressive external ophthalmoplegia (CPEO), mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS), and myoclonic epilepsy and ragged red fiber (MERRF) disease [3,4]. However, family studies showed considerable variability in phenotypes leading to the debate as to whether "mitochondrial diseases" should be split into subphenotypes or lumped into larger categories ("splitters" versus "lumpers"). This ambiguity was resolved by the demonstration that mtDNA mutations could cause disease [5–8] and the realization that cells can have thousands of copies of the mtDNA. The high mtDNA ploidy could then accommodate different percentages of mutant resulting in variable biochemical defects and diverse phenotypes [9]. It is now clear that pathogenic mtDNA mutations are not rare, but common. The prevalence of pathogenic mtDNA mutation cases has been estimated at 1:4300 [10–13], but greater than 1:200 newborn cord bloods harbor one of the 10 most common pathogenic mtDNA mutations [14].

Current estimates of the prevalence of mitochondrial disease are based on "primary mitochondrial diseases," those that are caused by nDNA or mtDNA mitochondrial gene mutations that are severe enough to cause a clinically relevant disease by themselves. The phenotypes and mtDNA and nDNA mutations associated with primary mitochondrial diseases were reported in our previous chapter in this series [15], with a current listing of the nDNA and mtDNA genes implicated provided in MITOMAP [16].

However, even in the early days of clinical mitochondrial genetics, it was clear that nDNA gene mutations could alter mtDNA structures, which alter mitochondrial functions and which generate mitochondrial disease. It is now clear that mitochondrial bioenergetic dysfunction, often resulting from faulty nDNA–mtDNA interactions, is prevalent and associated with the etiology of a wide range of metabolic and degenerative diseases and aging. Thus, the characterization of mitochondrial medical genetics during the past 30 years is restructuring the way we understand human genetics and reorienting the way we investigate the etiology of common diseases.

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Transcultural Psychotherapy

Thomas E. Heise, in Encyclopedia of Psychotherapy, 2002

Case History 4: Treatment of Hallucinatory Psychosis with Complementary qigong Exercises

Taiji quan (T'ai Chi Ch'uan) "shadow boxing" and qigong (Ch'i Kung) meditative "breathing exercises" are therapeutic methods based on traditional Chinese medicine (TCM), like herbal medicine or acupuncture. There are several forms of exercises, some of which are becoming more popular in the Western sphere. At first glance only the movements bear a vague resemblance to our established forms of gymnastic exercises, but the exercises based on TCM are, in fact, far more advanced. By means of a balanced form of movement according to the yinyang concept, the meridians are harmonized and the activated subtle energy qi also contributes to balancing the associated functional organic system. According to TCM theory, certain emotions and mental conditions are associated with specific organs, and with the help of these exercises, a psychotherapeutic effect is obtained. It was shown in a recent study by Heise in 2002, that qigong reduces in psychosis significantly state anxiety after each session and trait anxiety on the long term (STAI) and depression and psychoticism (SCL-90-R), increases relaxation and ability for enjoyment, helps exhaustion and achievement, and diminishes cenesthesia (case histories).

The 40-year-old patient complained of hearing voices for 4 years. The physical problems in his arms and legs and his headaches had persisted for 3 years and were induced by voices with their lips on his body. He initially tried to block out the voices by "drowning" them with beer, then gave up drinking, and since one year, had only consumed limited amounts of alcohol. The patient could for the first time be convinced of the advantage of persistent high-potency neuroleptics while undergoing day clinic therapy. Organic causes were ruled out and analgesic medication reduced. During the group therapies he demonstrated an aggressive inhibition with withdrawal tendencies on confrontation with conflicts. In addition, he took part in 5 of the above mentioned qigong therapy group sessions, and then a further 11 sessions on an outpatient basis following discharge. During day clinic therapy, the patient appeared to be considerably more relaxed, more lively, and more socially active with increasing clarity of mind, and experienced reduced physical pain and fewer headaches with weaker and less aggressive auditory hallucinations. It was noted on qigong therapy that even at the beginning he was able to rapidly develop the special "qi-feeling." On discharge from the day clinic he reported that immediately after the qigong, the voices disappeared for an hour and the headaches became less frequent. He felt an inner calm. Up to the 6th session he admitted to changes in his condition with regard to the voices and the "headaches," showing a slight improvement. The physical pains disappeared completely He executed these exercises independently twice a week, and continued to do them when followed-up for research purposes 1 month and then 4 months later, as he found they helped to combat the more aggressive voices, which now appeared about two times each week. He then received his third kind of a typical neuroleptics, and although he was unable to differentiate between these medications, he was aware that they had a certain beneficial effect on his condition, but less so than the qigong exercises, which he would practice whenever needed.

In order to deal with ethnocentric feeling and thinking, new solutions are required for the basic points of transcultural psychotherapy. These are not yet statistically validated, but need further investigation in this rather new field of research. Special issues are the question of value and purpose ("honor") regarding self-responsibility and self-realization in different cultures together with its role in psychotherapy. For example, a supervisor of the same foreign culture in an analytically oriented self-experience group for social and medical professionals may help to combat hostility toward foreigners. He reduces defense mechanisms, because he has overcome these troubles himself.

Weekend seminars to discuss crisis intervention with youngsters of the same culture, using the group analytical method, may be effective in reducing violence. Thus underaged refugees may have the opportunity, during this session, to discuss, in an appropriate manner with their peers, their traumatic experiences of leaving their parents and their native culture. Different psycho therapeutic forms such as hypnotherapeutic and cognitive-behavioral therapeutic techniques may be effective, as well as ritual techniques and eye movement desensitization and reprocessing (EMDR) developed by Francine Shapiro and published in 1997, as discussed by Foa and colleagues in 2000 and Sack and co-workers in 2001.

For therapists treating in a foreign country, in their mother tongue, with deep psychological, systemic, and behavioral therapeutic elements, transference-counter-transference and the risk of regression are important factors. Sociocultural circumstances influence drinking habits and drug consumption strongly and should not be disregarded in any therapy, according to Lala and Straussner in 2001.

Systemic individual and family therapy (mono-and bicultural) is resource- and solution-oriented by means of esteemed and engaged neutrality combined with respectful curiosity, as discussed by Krause in 1998. In addition to the routine service of psychotherapeutic-sensitive trained interpreters, the patient is also an expert in his culture. This induces a paradigmatic change.

Positive psychotherapy developed by Nossrat Peseschkian in the 1970s is derived from the narrative elements of Middle Eastern fables. This kind of therapy judges bodily feelings, senses, achievements, social contacts, and fantasy regarding future decisions. A comparison of giving life meaning in Eastern and in Western cultures is often added in this transcultural approach, similar to other humanistic psychotherapies.

All of these therapeutic methods concentrate on the way each individual interacts with his or her environment. The respective cultural background is responsible for influencing and molding the senses of perception and sensitivity of each human being. Culture is a term incorporating the material cultural relics and daily customs, everything that language makes "producible," "approachable," and "conceivable." This includes specific conditionable senses of perception (particularly apparent in the Yogis and Masters of the hard qigong) and metaphysical experiences, speakable and unspeakable expectations, and constructed models. All of these are attitudes that are more or less "culture-bound," without calling them a "culture-bound-syndrome." However varied the climate and the people they originate from may be, common denominators may remain with regard to the same generation, gender, spirituality, (un-) employment, wish for a better life of one's children, and so on.

All of these points need to be considered within the complete context of therapy—consciously or unconsciously Certainly it would be more beneficial if this were to happen consciously and thus not uncontrolled. The rationalized, verbalized, and cognitive element has prevailed in the culture of the Western world over the past 2000 years; this is understandable when one reflects on its historical development. However, domination of this kind of thinking must not be accepted to such an overwhelming extent. Therapeutically, it is significant to attempt to discover the other elements in oneself, which one has either never or rarely recognized before, or which have not had the chance to develop properly. A feeling of amazement or astonishment must be produced, which leads to a realigning of the thoughts by thinking twice. This change of "sense(s)" cannot only be achieved by verbal tactics but also by other therapeutic techniques. This change of the senses may give another sense and meaning to living. This initiates a healing process that materializes into the human system and its culturally influenced relationships toward fellow humans and the cosmos, as a whole, in an intrapersonal, interpersonal, and transpersonal way The therapist is the catalyst of this process, acting as a mediator to promote the self-curing efficacies of the patient.

It is interesting to note what effect this has on therapists, regarding their personal and professional development in relation to their feeling toward their own native culture, when one is constantly identifying with the patients and their foreign cultures, having to distance themselves in the next moment to assume the role of the catalyst once more.

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Complementary and alternative medicine

Brian Berman, ... Chris D'Adamo, in Rheumatology (Sixth Edition), 2015

Treatment

The TCM system encompasses many different treatment modalities, each, according to traditional theories, used to shift the vital energy of the body. Many of these techniques stimulate specific points on the body to alter the flow of qi (a term frequently used to describe the life force or energy in the body); usually, these points are located on meridians (specific channels that carry qi though the body; Fig. 48A.1). Acupuncture involves the insertion of thin, stainless steel needles into these points. Internal remedies are a vital component of TCM. These herbal remedies are always given in combination and are chosen to complement and balance each other. Additionally, TCM incorporates a unique system of massage called tui na and uses meditative exercises such as qi gong.

The TCM approach to rheumatic disease is very different from that of conventional modern medicine. The concept of rheumatic disease as it is understood in the West does not exist in TCM. The TCM treatment of rheumatic disorders, as in many CAM disciplines, is individualized, and the majority of rheumatic disorders fall into the general classification of painful obstructions (bi syndrome). Consequently patients with the same conventional diagnosis may receive different TCM diagnoses and treatments.

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Models and research in CTs

David Peters MBChB DRCOG MFHom MLCOM, ... Sue Morrison MA FRCGP, in Integrating Complementary Therapies in Primary Care, 2002

Model

Traditional acupuncture is based on the concept of Qi (pronounced 'chi'), loosely translated as 'vital energy' or 'life energy'. This is something thought to be present in all living organisms and which also finds expression in the surrounding world. When Qi is 'in balance' the person is healthy, but if it becomes deficient, is present in excess or 'stagnates' then illness will eventually manifest. According to TCM theory, Qi travels along pathways called meridians, along which are certain points (called acupuncture points or acupoints) at which Qi may be brought back into balance by various physical methods.

Neurophysiological processes help to explain some aspects of acupuncture. In particular, its effects on pain are at least partially explicable within the conventional medical model. For example, acupuncture stimulates A-delta nerve fibres and thereby closes pain gates through spinal cord pathways. Needling also stimulates the release of endorphins, serotonin and other neurotransmitters. Perhaps these findings throw some light on how needling in one part of the body can influence pain sensation elsewhere. Consequently, many doctors, physiotherapists and nurses, as well as some chiropractors and osteopaths, use 'dry needling techniques', generally at myofascial trigger points. Indeed there is a high degree of correspondence between 70–80% of acupuncture points and the sites where myofascial trigger points most commonly develop. 'Medical acupuncturists' make their diagnosis conventionally, often having dispensed with traditional concepts entirely. Some even dispute the existence of meridians and points, although there is evidence that there may be patterned functional relationships that connect peripheral nerve junctions and trigger points. Although our team does not dispute the value of medical acupuncture, we believe that it constitutes only a small part of what acupuncture as a whole can offer. We have found traditional diagnosis and treatment to be useful in ways that the available research-derived evidence does not yet adequately reflect.

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Breast Cancer

Judith Boyce MD, CCFP, in Integrative Medicine (Second Edition), 2007

Mind-Body

Since the mid-1700s, physicians have been noting that emotional factors play a role in the development of cancer. They record hearing stories of loss, grief, and hopelessness that were present before the early signs of cancer were observed. When surgery and irradiation became available early in the 1900s, the focus shifted to the diseased body part, and this focus remains the case in many conventional treatment centers today. The concept that cancer develops as a result of the whole person experience has resurfaced, however, and is gaining momentum as an area of interest and study.43

Over the past 20 years, the term type C personality has been coined to describe a coping style that may predispose to chronic diseases such as cancer. Type C personality has been described as a biopsychosocial coping pattern, in which the denial and suppression of emotions, particularly anger, contribute to the multifactorial origins of cancer. Suppression of emotions may lead to negative coping styles, such as helplessness/hopelessness, which are associated with suppressed immunity.44,45 Reactive depression, with feelings of helplessness and hopelessness, is common in people with cancer.43

Evidence for a relationship between psychosocial factors and the development of breast cancer is weak, but it exists. There is a positive association between rationality, anti-emotionality, repression, major life events, and stress at work and the risk of breast cancer.46,47 Findings also indicate that the post-diagnosis clinical course of breast cancer may be influenced by the type and duration of particular ongoing stressors.45

Energy Medicine

According to many traditional belief systems (and some latter-day quantum physicists), the body is surrounded by an energy field, with vital energy entering and leaving the body through several specific emotional or energy centers, or chakras. Practitioners of energy medicine believe that the human energy field is unique to the individual and that it surrounds and carries with a person the emotional energy created by life experiences—good and bad. Their premise is that emotions from life experiences become encoded in biologic systems and contribute to the formation of cellular tissue—healthy or diseased. Emotional forces can affect physical tissue; in this way, emotional pain and trauma manifest as physical symptoms or disease.48 Practitioners of a number of energy therapies, including Reiki therapy, healing touch, therapeutic touch, polarity therapy, and acupuncture, aim to access and work therapeutically with disrupted or blocked energy centers, with the goal of relieving physical or emotional symptoms.

In energetic terms, the breasts are located in the fourth chakra in the center of the chest. Fourth chakra energy, said to be emotional in nature, is associated with the ability to express joy, love, grief, and forgiveness as well as anger and hostility.48 Energy medicine practitioners believe that repression or blocking of these emotions affects the health of all the organs in the fourth emotional center, which includes the lungs and heart as well as the breasts. If there is a chance that breast cancer is in part the result of stressful life events that have love or loss at their core, physical healing must take into consideration the healing of emotional pain and trauma.

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