Long-COVID & Acupuncture: the Mind, Chronic Deficiencies & Deep Change
The mental state has a profound impact on our physical health. It can help or hinder the healing process. Long-standing chronic deficiencies also have an effect. They are usually linked and must be addressed for deep healing to occur.
Recently I’ve been treating several people for long-COVID symptoms, especially those involving ongoing chronic fatigue, muscle weakness, respiratory and digestive issues. Through acupuncture we’ve been able to make big changes in their physical health.
Some of these patients improve gradually, regaining much of their physical health and stamina. Others seem to improve for awhile and then backslide into recurrent bouts of illness. It can be confounding as to why some people get better and others go back and forth between illness and health. Through my many years of experience as an acupuncturist, and especially through this recent period treating long-COVID patients, I’ve noticed the impact of the mind is key.
My longtime teacher would often say healing is more than just the alleviation of symptoms. To fully heal one must change the consciousness that has been supporting the illness. The greatest of all acupuncture textbooks (written over 2000 years ago) teaches that whatever the illness, healing must involve the spirit (mind and emotions), otherwise it will be incomplete.
This can be tricky, especially when dealing with patients who have an aversion to entertaining conversation about the mind, emotions or the spirit. Not to say that we need make every physical ailment into a mental or spiritual disease. But when mere physical-oriented treatment is not working, I have found addressing the mind, emotions and spirit becomes essential.
Often people will fixate on physical problems, Western biomedical diagnosis and even getting many many different opinions to avoid dealing with the underlying reasons for their inability to heal.
I’ve also noticed that may people suffering from ongoing long-COVID symptoms possessed chronic underlying conditions such as autoimmune, degenerative or mental-emotional conditions before contracting COVID, many of which were either undiagnosed or untreated. Many of these conditions led to states of chronic deficiency that left them vulnerable and unable to fully heal.
For several of my patients working to resolve their long-COVID symptoms has required addressing their more long-standing chronic issues. It has even brought to light conditions and tendencies of which they were either unaware or in denial.
The hard truth of healing often comes down to this: healing means change. We can manage symptoms for a long time, but to fully heal from something often requires changing something about ourselves and/or our lives. We cannot keep living, thinking, feeling and behaving in the same way, because these are usually the energy sources that continue to feed our illness.
Changing can be very hard: painful, scary and unsettling. Healing can be like getting sober from drugs and alcohol. First we have to admit there’s a problem: that we are contributing to our own illness. Then we need to take stock of our lives, and have the courage and discipline to make changes. Often we need support in doing this, in the form of a healer, therapist or group.
We in the West are dis-served through our belief that the mind and body are separate. This is why the Eastern healing traditions have become so popular: they see the mind and body as inseparable. They affect one another. To me this is not just a theory or concept. I see it daily in my acupuncture practice.
When a person comes to me with a deficiency, I prescribe herbs or do acupuncture treatment to build back their energy reserves. I can measure this through pulse diagnosis. Through the pulse I can assess the functional energy of each of the internal organs.
I work on a person until all of the pulses have regained their vitality. Yet if a person returns a week later and the pulses have emptied of their vitality, I have to ask them why. What is it in their lives or thought processes that consumes their energy? What is burning up their blood and fluids, and scattering their mental-emotional energy? I can continue building back their energy forever. But for the person to fully heal, they need to become aware of what is causing their energy depletion. From there we work on being able to make changes.
Healing is often a slow process. It takes time to first of all identify the problem, and often even more time to change behavior and retrain the mind.
In the case of some of my long-COVID patients we have discovered unrealized autoimmune tendencies. For others we’ve had to acknowledge lifestyle and thought patterns that have been draining their energy for years, leaving them in an energy deficit. Beyond just working to alleviate the symptoms of long-COVID, we are having to address long-standing problems that left them vulnerable to the effects of COVID, allowing the acute infection to have chronic effects.
I have noticed with may who suffer from long-COVID that the condition impacts their Spleen and Lung energy. Sometimes also the Kidneys and Heart.
The Lungs, Spleen and Kidneys are collectively called the “Triple Heater” in Chinese Medicine: a term that refers to the interchange of energy from the root constitutional energy of the body to the digestive and respiratory systems, empowering the immune system as well as fluid metabolism and even endocrinology. The Triple Heater relationship to the Heart impacts blood circulation. The relationship between the Heart and Kidneys impacts the willpower and the mind-spirit, often manifesting through sleep and mental-emotional stability.
One of the most popular and revered schools of Chinese Medicine is called the “Earth School,” or the school that focuses on the Stomach and Spleen, the digestive system as the root of all healing. This is the approach I have been taking in treating many long-COVID cases.
COVID seems to hit the energy of the Stomach, Spleen and Lungs chiefly. It appears to create a deficiency and/or disruption in the Spleen-Stomach which is the root energy that feeds the Lungs. Phlegm can result and/or a depletion of energy. This is what can cause the fatigue, brain fog, susceptibility to catching cold and flu as well as the chest pain and limb weakness often reported.
The Stomach-Spleen or “Earth” is also seen as the root of the mind and stability of the emotions. The Liver is always balancing itself with the Spleen. Obsessiveness, rumination or habituation are states associated with the Spleen, while depression, anger and frustration is associated with the Liver.
A weak or “damp” Spleen will often cause the Liver to become stagnant, leading to symptoms. A stagnant Liver can cause digestive problems to become exacerbated. These two organs are a naturally harmonious pair, yet when one falls out of balance, the other can often attack or harass its partner. The same is true with the Stomach and Spleen. Their disharmony can lead to dysfunction of energy flow in the body, causing the Stomach to rebel in the form of nausea, vomit, hiccups, acid reflux. Or the Spleen in the form of loose stool, diarrhea, hemorrhoids or other prolapse symptoms.
When the Spleen is weak or the Liver is stagnant there will often be an effect on the Lungs, causing immune deficiency, wheezing, hypersensitivity, skin problems, coughing, phlegm, ear-nose-throat problems. There can also be a lack of energy and easy fatigue.
Autoimmunity often targets the Spleen system in the body. This is seen in Chinese medicine as rooted in an unresolved infection or affliction that becomes stuck in the body, generating inflammation that either attacks the tissues (and energy resources) of the body or resides as a latent, low grade issue that comes and goes as flares and remissions. Diabetes is an example. There were many reports that people with Diabetes were hit especially hard by COVID. Other autoimmune conditions have similar effects.
But the Spleen-Stomach “Earth” system is also seen as the root of the mind. It provides the energy for mental clarity and cognition. The Liver is that which “harmonizes” the emotions. The Spleen is that which clarifies thought allowing it to be sharp and clear. Therefore longstanding depression, obsessive tendencies, or other mental-emotional disorders show a weakness or disharmony between the Spleen and Liver that can also exacerbate long-COVID cases, preventing full resolution.
The “Earth School” teaches that problems with the Stomach-Spleen will always hamper full healing of any condition. Therefore it is important to address lifestyle behavior and thought patterns that weaken the Stomach-Spleen or stagnate the Liver. Diet is important, but also the way we process our thoughts, emotions and experiences.
Acupuncture is the most direct way to address energy dysfunction within the body. In many cases, long-COVID patients have found acupuncture to be the most successful avenue for helping eliminate their symptoms. In most cases, I have used treatments that strengthen the Spleen and Stomach to support the Lungs, along with acupuncture points that “open the chest” to free the emotions and eliminate mental stress.
This is the classic recommendation of the “Earth School”: the “Axis of energy movement” in the body must be “rectified.”
The Stomach’s energy naturally descends, allowing for proper appetite, ingestion and elimination.
The Spleen’s energy ascends to feed and support the Lungs and Heart which then circulate energy and blood to the rest of the body.
This is the digestion process, of which there are two parts: the ability transform (digest) and transport (circulate and distribute). When either of these energy vectors is hampered, symptoms of “rebellious energy” will result, which disrupts proper digestion and elimination but also appetite, immunity and thought. Rebellion in the Stomach-Spleen can lead to problems in the Lungs: cough, wheeze, phlegm ect.
The second part of the Earth School strategy involves dealing with the emotions including proper processing and expression.
Emotions that are unable to express is called “Yin Fire,” suggesting inflammation due to suppression of feeling or experience. The Pericardium acupuncture channel is used for this purpose.
The Pericardium holds onto the traumas and disappointments of life. It is a channel that can maintain a sense of victimization and vulnerability. It has a strong relationship with the Liver, which is said to “store the blood,” which also means the storage of experience which in the case of the Pericardium can be toxic or maligned, leading to states of autoimmunity or lurking inflammation that constantly deplete a person’s energy, or haunts them via a phlegmatic stagnation .
Once energy movement (including emotional expression) is addressed, its possible to begin rebuilding the body’s energy and vitality.
Yet I often see the reverse with patients. Even when I strengthen and build back their energy, they still return to my office weak and depleted. This has shown me that energy and vitality is predicated on proper movement of energy and free expression of emotions.
The Earth School teaches that we cannot rebuild and restore our vitality until we’ve “rectified” our emotional expression and restored proper movement of internal energy flow. We must learn to harmonize our thoughts and emotions, and return to a natural instinctual flow where we can take in and let go.
The problem for many of us is we don’t know how to let go. We are either constipated physically or emotionally. We hold onto too much. Or we obsess about things, worrying unnecessarily. This weakens the Stomach-Spleen and stagnates the Liver.
Within the Chinese medical way of thinking the energy of the mental and physical are the same. The workings of the mind impacts the physical and vice-versa. In fact, they are often mirroring one another. This is why digestive issues and dysfunction such as IBS, colitis, crohn’s disease often require working with the mind and emotions.
The mind and emotions are a type of digestive process themselves. Just as faulty digestion can cause immune response, the same is true for emotions that don’t fully process and release. Emotional toxins can remain stuck in the body creating hypersensitivity and inflammation that drains the body of its energy and harasses the mind.
The flagship herbal formula for the “Earth School” strategy is called “The Central Qi Tonic: Bu Zhong Yi Qi Tang.”
This Formula contains several herbs that strengthen the vitality of the Lungs and Stomach-Spleen including Ginseng (Ren Shen), Astragalus (Huang Qi), Atractylodes (Bai Zhu) and Licorice (Gan Cao) which comprise the most standard energy building combination in Chinese medicine, called the “Four Gentlemen Combination: Si Jun Zi Tang.”
However this formula also contains herbs that “raise energy,” supporting the Spleen in its ascending action. Bupleurum (Chai Hu) and Cimicifuga (Sheng Ma) circulate the energy of the Liver but also direct energy upwards for expression, helping the Spleen in its natural ability to allow a sense of lightness of body and mind.
The herb Angelica (Dang Gui) both nourishes and moves the blood, to allow the emotions to be both supported and circulated. The combination of these herbs allows energy support, blood support and movement so the emotions and thoughts do not get stuck.
This formula treats “Yin Fire,” which is described as a type of fever and agitation that comes from energy deficiency. The body lacks sufficient energy and ascension to express the emotions, allowing them to smolder within. The meaning contained within this formula teaches that we can only rebuild our vitality once the capacity for emotional expression has been rectified and restored.
Classical herbal formulas are important in that they convey the strategies and ideas from the famous classical schools of thought that created them. The formula in itself is effective, yet the ideas and strategies contained with it can be used as a basis for an approach for healing.
When assessing someone with long-COVID, I first identify which organ system is weak. Is it the Stomach-Spleen, the Lungs or the Kidneys? This will clarify which organ system I will direct the energy-building into.
Naturally all three organ systems need to be addressed to build back energy depletion, yet the root problem must be given the most focused attention once it is discovered.
The art of healing involves identifying what is the Root of the problem and what is the Manifestation. Symptoms are not always indicative of the root. For example, Lung symptoms like fatigue and tendency to catch cold can be treated by the famous formula called the “Jade Windscreen Formula: Yu Ping San.” Like the “Central Qi Tonic” this formula contains the herbs Bai Zhu and Huang Qi, but it also contains the herb Siler (Fang Feng) which allows the formula to act like a type of shield for the body to prevent those that are weak from catching colds.
However, the “Jade Windscreen” might not treat the true root problem if the weakness comes from the Stomach-Spleen or the Kidneys. Stomach-Spleen means the root is in the digestive system; Kidneys means there is a deeper weakness that might be constitutional.
The key aspect to the “Central Qi Tonic” are the herbs that support the ascending energy of the Spleen.
When the Spleen is the root of weakness in the body, focus must be placed on helping its energy to ascend so as to support the Lungs and distribute energy into the chest, head and limbs.
If the Kidneys are the root of the weakness, a stronger formula should be used that is more warming, as the Kidney system is the root of the body’s transformational Fire. This will usually show itself in severe digestive problems, diarrhea, debilitating fatigue and even edema.
Acupuncture is like a form of energetic physical therapy. It re-trains the body how to function on a deep internal level. Herbs also do this, if more indirectly.
The acupuncturist acts like a quick shock to the system, quickly redirecting energetic flow to work at its optimal level. With herbs. the patient must develop a relationship with the spirit and action effect of the herbs. Ideally the acupuncture treatment will focus and prepare the body, while the herbs help to continue the intention of the acupuncture session.
This discussion is only one situation of a long-COVID case. Chinese medicine focuses on the individual and their specific chemistry, rather than on the disease itself.
Chinese medical thinking believes a person always has the capacity to heal from a disease or situation. Therefore much attention is paid to a person’s physiology: the way in which they are or are not strong enough to heal themselves. This is therefore what is addressed specifically when treating a person. A disease may be the same in several people, but the physiology is often different.
For a person to heal, their physiology is often what needs to be supported. To focus solely on the disease is often not enough. Especially in the case of long-COVID where longstanding prior physiological issues are often the cause of the current inability to fully recover.
This article is a discussion of a patient for whom the Stomach-Spleen was the root of the problem. However, if the Gallbladder or Liver was the root of the problem, the herbs and acupuncture strategy would be different. More discussion for further articles.