Adaption in Mind-Body Integration Practice
Understanding Variations of Qigong Exercises from TCM Theories
by Kevin W Chen, Ph.D., MPH
When I started learning Qigong as a life-nurturing mind-body exercise and a convenient healing method, I was taught that one of the advantages in Qigong therapy was that one system or Qigong practice routine could be applied to various health conditions, and that it would fix all different diseases or problems. In other words, as long as you practice the same routine everyday, there would be no mistreatment or adverse effects like most modern medical therapies have. I assume that many Qigong students have heard similar statements, and agreed with this generalization. In comparison with the hundreds of thousands of different diseases classified in modern western medicine, each disease having multiple possible treatments or uncertainties,Qigong therapy does have simplicity and universal application in many senses. However, if you think one Qigong form or one system will fit all the different practitioners, and offer help for all different diseases all the time, that would probably be an oversimplification of the issue. As I am studying the history and development of medical Qigong, and read some classic works in medical Qigong therapies, I notice that variations by individual differences and adaption to the season, timing, and types of diseases are the keys to a successful Qigong practice and Qigong healing. Here are some main points I learned from the theories of traditional Chinese medicine (TCM) and medical Qigong. I would like to share with other practitioners so that we can make progress in this area together.
1. Apply the Theory of Yin-Yang and Five-Elements to Guide Practice
The theory of Yin-Yang and Five-Elements was fundamental for TCM development and application, which constitutes the basic model of nature, society and human life. In TCM the macro system of man and nature is reduced into two big paradigms of yin and yang; each of them can be further divided into sporadic yin and yang elements. That seeming simplicity implies complexity and changes, including the possible hierarchy and classification of this macro system. For the human body, the refined nutritious substances that constitute forms and structures are called yin essence; while the force driving all life movements is called yang Qi. Therefore, the basic nature of yin-yang is that yin governs quiescence (stillness) while yang governs motion; the two are actually one. Being a unity, they work together to keep the stable status of the system in a dynamic balance, by mutually depending, opposing, transforming, waxing and waning with each other. When the yin-yang is in balance, healthy status is maintained.
Ancient people said that, in practicing Qigong, one must ‘have a profound insight into yin and yang’. The first step of Qigong practice is to choose an appropriate method or form according to individual physical constitutions, since ‘people are classified into lesser yin (Shaoyin), greater yin (Taiyin), lesser yang (Shaoyang), Greater yang (taiyang), and balanced yin-yang types or groups. Each differs in shape, muscles, bones, Qi and blood. For patients, yin-yang hyperactivity or deficiency should be distinguished so that different Qigong forms can be assigned to different individuals to achieve the optimal results.
In the actual process of routine or fixed forms of Qigong practice, it is also guided by the yin-yang five-element theory. The dynamic Qigong forms pertain to yang while static Qigong forms pertain to yin. Yin and yang manifest themselves in every aspect of the three adjustments. Motion and stillness, opening and closing, relaxing and tightening, being soft and hard, bending and stretching, ascending and descending in body adjustment pertain to either yang or yin. Relaxing static Qigong can restrain hyperactivity of yang and replenish yin — ascending and opening upwards and outwards elevates yang, and descending and closing downwards and inwards restrain the hyperactivity of yang. The Collections on Medicine (医学汇函) recorded that “People suffering from pathogenic fire should practice Qigong with the eyes open while people without the pathogenic fire may do it with the eyes closed. When practicing Qigong, a person can guide the Qi upwards to treat ear, eye, mouth or nose diseases by bending his body backwards; treat the head disease by raising his head; and treat the diseases below his waist by focusing on his feet.”
It is equally true with the adjustment of breathing. Breath-in pertains to yang while breath-out pertains to yin. A Miraculous Canon on Long-life through the Original Qi (长生胎元神用经) recorded the following, “the fresh Qi taken in with the nose is yang while the turbid Qi coming out from the mouth is yin ….” Holding breath to retain Qi can eliminate the cold and breathing out the turbid Qi can clear the heat. Therefore, people with yang deficiency should focus on breathing-in and prolong the act of inhaling. People with yin deficiency should focus on breathing-out and prolong the act of exhaling.
The adjustment of mind includes also the change of yin-yang, especially in “keep the mind on” (意守) and mind-reach practice, fully characterized by the variation of yin and yang. Focusing on external sight can remove the heat fire, while focusing on internal sight can warm up yang. Imagining scenes of water and coldness can supplement yin, while imagining a scene of fire and heat can elevate yang. Just as Wen Shi Taoist Canon (文始真经) stated, “Qi is induced by the mind, as if contemplating a big fire inward, heat will be felt; contemplating a flood inward, cold feelings will ensue.’
Traditional Qigong practitioners have made it a rule to preserve health in view of the time variation of yin and yang as well as the four seasons. “Nourish yang in spring and summer, and nourish yin in autumn and winter.” If it comes to the 12 two-hour periods (时辰), practicing Qigong is helpful to yang during the six yang hours (from 11 p.m. to 11 a.m.) and good for yin during the six yin hours (from 11 a.m. to 11 p.m.). The corresponding internal organs will be nourished if the Five-zang organs, seasons, dates are matched in view of the generating and restricting relationships of the Five Elements. The application methods were mentioned in Treatise on the Essentials of Eating Qi (服气精义论) as following: “On the six Bing days in the Spring … (one) can nourish the liver Qi by eating Qi one hundred and twenty times for the heart, so that the heart fire can restrain lung metal, and lung metal won’t harm liver wood. On the six Wu days in summer … eating qi can help the spleen, so that the spleen earth can restrain kidney water, and kidney water won’t harm heart fire. On the six Geng days in later summer … (one) can nourish the lung by eating Qi … so that lung metal can retrain liver wood, and liver wood won’t harm spleen earth. On the six Ren days in autumn … (one) can nourish the kidney by eating Qi … so that the kidney water can restrain heart fire, and heart fire won’t harm lung (metal). On the six Jia days in the Winter … (one) can nourish the liver by eating Qi … so that the liver wood can restrain spleen earth, and spleen earth won’t harm kidney (water). ”
2. Use Meridian Theory to Enhance Qigong Practice
Meridian has also been translated as Channels and Collaterals, or Network Vessels, which constitute a network model of the human body. The theory of meridians is the foundation of acupuncture and Qigong therapies. Meridians are generally considered to be paths or channels, through which internal Zang-fu organs interact and are nourished with Qi, and the four limbs and bones are connected. Therefore, the abnormality of either the function or structure of zang-fu organs would lead to the malfunction of the meridian Qi, and further, can be observed from the condition of the limbs and bones.
The meridian theory plays an important role in concrete maneuvers of the three adjustments (body, mind and breathing adjustments) in Qigong practice. In adjustment of body posture, the phenomenon “a proper posture is followed by smooth Qi movement” indicates that the right body posture guarantees a smooth passage and flow for the circulation of Qi and blood. Patting and massaging were frequently carried out on one or several acupoints along the meridians. Kneading elixir fields and rubbing Yongquan (涌泉), for instance, are employed in health-preserving Qigong, and patting and striking the surface of the body along the route of meridians to help relax is employed in Relaxation Qigong.
Adjustment of the mind is also closely related to the meridians, especially the skill of “keeping the mind on” (意守). The places or areas where the mind is kept focused on are mostly the acupoints in meridians, such as the three Dan-tian (elixir fields) in the internal elixir arts, or the points for a breathing pause (Zhixi Dian, 止息点) in Relaxation Qigong.
It’s equally true for adjustment of the breathing associated with the “mind reach,” which induces clear meridians for the circulation of blood and Qi by focusing on breathing. Some components in fetal breathing, such as body breathing, elixir fields breathing, skin-hair breathing, etc. are also conducted by regulating the opening and closing of some acupoints.
The Eight Extra Channels are held in high regard in Qigong cultivation, especially by the internal elixir arts, which offer detailed explanations about this subject. As early as 400 B.C.E., it was mentioned in Zhuang Zi that “Taking the governor vessel as a main channel to cultivate enables one to stay in good health, strengthen the vital energy, and enjoy a long life.” Although the conception and governor vessels were not specified in the Jade Pendant Inscription of Circulating Qi, the notion was already very clear that the coordination between yin and yang could be obtained through breathing deeply to ascend and descend Qi along the meridian.
Li Shizhen was particularly in favor of the academic thought presented by the internal elixir arts, and expressed such opinions in his book A Study on the Eight Extra-channels. He stated that, “the internal scenery and channels can be viewed only by those who reflect inwardly”. The important role that the interaction of conception and governor vessels, yin and yang played when their Qi merged into each other was thoroughly discussed by the internal elixir arts. It was very likely that the ancients perceived and figured out the significance of regulating the system of nerves and body fluids in life through Qigong practice, and therefore, centered their Qigong cultivating and practicing forms on this system.
The three adjustments in Qigong practice have the function of unblocking meridians and collaterals. The feeling of warmth inside the elixir field or feeling the pulse jumping due to “internal Qi” movement may indicate that Qi-blood is circulating vigorously in that location. Continuous practice may produce a feeling of internal Qi moving along the meridians and collaterals. The forms of Grand and Small Cosmic Circulation Qigong are practical exercises to unblock meridians and connect channels and collaterals to each other. Just as the Incisive Light on the Source of Miscellaneous Disease · Rules of Employing Qi (杂病源流犀烛·运功规法) said, “Settle down to the earth and focus on the middle, then, direct Qi through the route of Cosmic Circulation for one lap to disperse obstructed Qi after matured practice.”
The fact that meridian transmission induced by Qigong practice, as well as the experimental study of the meridian phenomena during Qigong practice, have proved the role that Qigong plays in helping Qi-blood circulate along the meridian system. The phenomena of meridian transmission induced by a deep Qigong state when practicing Qigong or receiving emitted Qi has been reported in Beijing and Shanghai. Although we are still uncertain of the true nature and implications of the so-called “sensation of Qi”, the phenomena demonstrate that Qigong practice has a positive effect on the channels of the meridian system.
3. Theory of Essence-Qi-Spirit (精气神) and Mind-Body Practice
A crucial paradigm in ancient Chinese philosophy is that the essence Qi refers to the existence of refined substances. The word “essence Qi constitute things” appeared in The Great Treatise from The Book of Changes (周易·系辞传) without detailed elaboration. The theory of essence Qi was given a detailed explanation in Guan Zi (管子), in which essence is regarded as refined micro Qi, “Essence is the essence of Qi”. It was also stated that the essence Qi was the source of life as well as the source of the wisdom for the Sages. It was said that “Conforming to Dao ensues Qi; Qi generates thought, and thought makes Dao known”. Therefore, human life came to exist owing to the connection between the essence Qi and the body, and then, life generated the ability to think – a function of the spirit (Shen) that owes itself to life.
The theory of Chinese medicine has not only absorbed and carried forward the above mentioned philosophical thinking, but also made it more specific. Its basic understanding of the concepts concerning essence, Qi and spirit are as follows.
Essence refers to all refined and nutritious substances, and is the material basis for the construction of the human body. Plain Questions: Sincere Remarks on the Synopsis of the Golden Chamber ( 素问·金匮真言论) said, “Essence is the base of the body.” Spiritual Pivot · Meridians (灵枢 · 经脉) said, “The essence is a prerequisite to a person. Once essence comes into being, brains and marrow will grow. The bones act as a stand of the body; meridians act as passages to nourish it; muscles help fix bones; and the flesh acts as protection. Hair grows after skin becomes strong.” Plain Questions · On True Man of the Remote Antiquity said, “Kidney accepts and stores the essence of five-zang and six-fu.” Therefore, every part of the body contains the essential element and all the organs are based on essence.
Qi is a refined nutritious substance or a functional activity of the organs in the body. The significance of Qi is just as The Eighth Problem from the Classic on Medical Problems (难经·八难) states, “Qi is the root of the human body. If the root died, all the stalks and leaves would wither up and perish.” Please refer to Dr. Elsen’s series on scientific exploration of Qi for a concrete definition and discussion on “Qi”.
Though intangible, Shen or spirit in TCM is the governor of life and represents the initiative of life activities. It is, in fact, the regulating and controlling mechanism inherent in life, namely the regulating information of life activities, including thinking, spiritual activity and the instinctive regulating and controlling functions. Spiritual Pivot said, “The original substance of life is called essence. When yin essence and yang essence combine, spirit is produced.” The material basis for the spirit is the interaction of the essence Qi, and all its activities have to rely on the acquired nourishment.
The theory of essence-Qi-spirit has not only been of interest to TCM doctors and widely applied in medical practice, but has also drawn much attention from enthusiasts of Yang-Sheng (life nurturing). Essence, Qi and Spirit are taken as the original life drive and the material basis of life in the Daoist school of life-nurturing Qigong. Hence the terms: three-yuan (三元, a collective name for the locations of the three elixir fields), three-cai (三才, a collective name for Heaven, Earth and Human) and three-bao (三宝, a collective name for essence, Qi and spirit ).
As Dong Dening (董德宁) wrote in Annotations on Awakening to the Essence (悟真篇正义), “San Yuan (三元) is equivalent to the three powers (San Cai, namely Universe, Earth, and Man), which refers to the three lights in heaven: the sun, the moon and the stars; the three elements on the earth: water, fire and earth; and the three aspects in human body: essence, Qi and spirit.” Mind-Seal Scripture of the Jade Sovereign (玉皇心印经), an ancient book on Qigong, said, “The upmost three ‘medicines’ are essence, Qi and spirit.” In Volume XXVIII from Classic of Categories (类经·卷二十八), Zhang Jingyue also pointed out, “ Thousands of words in my books on cultivation have come to nothing but the invention of the three words: essence, Qi and spirit.”
Indeed, traditional Qigong practice revolves around the cultivation of the three elements, aiming at keeping fit and attaining longevity by regulating, nourishing, resuming and replenishing essence, Qi and spirit. Different conditions or combinations of the three treasures would require different ways of Qigong cultivation or different practice forms.
Approaches to Nourishing Life without Taking Medicines (勿药元诠) stated that, “It is a process from nonexistence to existence by storing up spirit to produce Qi, and storing up Qi to produce essence. It is going from existence to nonexistence by refining essence and converting it into Qi, refining Qi to nourish the spirit and training the spirit to return to nothingness (虚) ” That’s how the ancient people understood human life. The spirit is occult, but as the vital information, it directs the functional activities to absorb nourishment from the outside to duplicate itself, which is a process from nonexistence to existence. On the contrary, consuming food and energy and transforming them into information for mental and functional activities is a process from existence to nonexistence.
Mind-body integration practice or Qi cultivation is, after all, no more than cultivating essence, Qi and spirit and maintaining these three treasures. In other words, it is a process of metabolism to manage the mutual transformation among information, energy and substances through mind adjustment, which is in perfect accordance with Yin-Yang theory. Effective Approaches to a Long Life (寿世青篇) said, “Refine essence and convert it into Qi and train the spirit to return to nothingness. However, where to start? The first stage is always concerned with the mind.” These words show that the key to Qigong practice is to adjust the mind so that it can dominate the generation and transformation of essence, Qi and spirit. Given the virtuous circle of the metabolism, the full essence and spirit can be stored up, and the body and spirit can be kept steady in the unity of opposites over a long period of time. Such is the condition under which good health and longevity ensue.
More specifically, purifying the mind and diminishing desires contribute to keeping mental tranquility and avoiding mental waste. With fair, but no stray thoughts, there will not be any doubts in mind. If so, all activities of the organism are likely to be in conformity with the principle of health-preserving, i.e. the law of nature. As Spiritual Pivot · Central Zang (灵枢·本藏) said, “A person’s will enables him to control his mind, constrain his hun-spirit (魂) and po-spirit (魄), adapt himself to the environment and moderate his mood.”
In the process of the three adjustments, when one focuses on the lower dantian, the heart fire can descend to warm kidney water, avoiding the “frenetic stirring of ministerial fire”, the yin essence, can therefore, be maintained. And, as fire can generate spleen earth, the acquired essence will be replenished, and the inborn essence nourished.
Adjusting the breathing quietly can stop the genuine Qi from consuming, and blowing out the old and breathing in the new helps replenish the pectoral Qi. When the elixir field is permeated with Qi, the original Qi returns to where it comes from and the food Qi will be sufficient. With adequate Qi, ample essence and thriving spirit, those who have suffered from diseases will be restored to health naturally and live a longer life.
Understanding the relationships between TCM theories and mind-body integration practice is really the key for us to adapt appropriate Qigong forms and techniques to achieve optimal results of mind-body practice. Just as the old saying states, “there is no fixed method in true Dao (法无定法)”; only through our own exploration and experience can we find out what is the best way to follow for our own mind-body integration practice.
[Kevin Chen, Ph.D., MPH is an associate professor at the Center for Integrative Medicine and Department of Psychiatry, University of Maryland School of Medicine (USA). Dr. Chen was educated in the universities of both China and the United States, and has years of experience and training in blending eastern and western perspectives, and in the practice of life-nurturing methods. As a long-time practitioner of Qigong Yang Sheng, he is one of the few scientists in the U.S. to have both hands-on knowledge of mind-body practice, and an active research career in mind-body medicine, which is funded through grants by the National Institutes of Health (NIH) and various foundations. Dr. Chen devotes his career and life to the practice of Yang Sheng, and promotion of self-healing and mind-body-spirit integration through the non-profit organization, World Institute for Self Healing (WISH) (http://www.wishus.org).]
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