Zhi-rong Li,Jian Du,Hao Wang,Ya-nan Gong,Zhen-zhu Liu,Xiang-yun Xu,Qiu-li Yang＊

1.Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong Province,China;

2.Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China

Abstract

Key words:psychosomatic medicine; TCM theory of emotion; modern psychological emotion theory;clinical application

Theoretical Basis

Psychosomatic medicine investigates the psychological and physical medical problems and targets psychosomatic diseases[1].Traditional Chinese medicine （TCM） theory emphasizes the holism concept and advocates the unity of body and spirit,which proposes that the spirit and body are inseparable,and they influence and interact with each other.The spirit depends on the body and has a counteraction on the body,which is specifically characterized as follows[2]:the spirit is generated based on the body and closely relates with the body.As stated by a common saying,the spirit exists then the body exists,the spirit perishes then the body perishes.The spirit relies on the body and exerts its function on healthy body,the body is the material basis of the spirit; the spirits also affect the body,namely the counteraction of psychology on physiology.As stated in Plain Question Yiqing Bianqi Lun Chapter,vitality indicates a favorable prognosis and loss of vitality indicates a fatal outcome.

Under the guidance of the theory of the unity of body and spirit,psychosomatic medicine studies the relationship between spirit and body and its role in the occurrence,development and outcome of diseases.Psychosomatic medicine involves the fields of both medicine （physiology）and psychology （emotion）,and the unity of body and spirit provides a theoretical basis for the development of psychosomatic medicine.

Emotional Theory under the Psychosomatic Relationship

TCM emotion theory

Emotion is an important concept of TCM psychology.It is a collective term of seven emotions and five minds.It is the overall summary of common emotional states in human spiritual activities,and is a unique and basic concept of TCM field for human mental and psychological activities[3].In TCM theory,the emotions include seven emotions （joy,anger,melancholy,anxiety,grief,fear,terror） and five minds （joy,anger,anxiety,grief,fear）,which are the external manifestations of human spiritual activities.

The generation of emotional activities depends on the functional activities of the viscera,and the essence qi of the viscera is the physiological basis of emotional activities.As stated in Plain Question Yinyang Yingxiang Dalun Chapter,five internal organs produce five qi in the body,namely to produce joy,anger,anxiety,grief,melancholy,fear.As stated in Plain Question Wuyunxing Dalun Chapter,the liver is affected by anger,the heart is affected by joy,the spleen is affected by anxiety,the lung is affected by melancholy,and the kidney is affected by fear.Different emotional changes have different effects on the viscera.Anger impairs the liver,joy impairs the heart,melancholy impairs the spleen,anxiety impairs the lungs,and fear impairs the kidneys,as shown in Plain Question Yinyang Yingxiang Dalun Chapter.Changes in emotions will also affect the qi movement in the viscera.As stated in Plain Question Jutong Chapter,all diseases are due to the disorder of viral energy,anger leads to qi ascending,excessive joy leads to qi loose,excessive grief leads to qi consumption,fear leads to qi descending,terror leads to qi turbulence,and anxiety leads to qi stagnation.It can be noted that,emotions are closely related to the viscera.Seven emotion stimulating and disorder of qi movement are important factors that cause psychosomatic diseases.The TCM emotion theory promotes the development of psychosomatic medicine and has guiding significance for modern diagnosis and treatment of psychosomatic diseases.

Modern psychology emotion theory

With the development of modern medicine,in the researches of modern psychology theory regarding the emotion,emotions are shown to be closely related with the body.

In the James Lange’s theory of peripheral feedback emotion,emotional experience is mainly caused by physical changes.Emotional stimuli can trigger physiological responses of the body,while physiological responses further lead to the generation of emotional experiences.As the emotion theory develops,researchers propose the facial feedback hypothesis,describing that an individual emotional experience is closely related to the activities of facial muscle.In addition,some researchers also discover that the feedback of individual physical activity,body posture,voice rhythm and intonation,as well as other sensations also affects the individual emotional experience[4].Damasio et al[5]propose the somatic marker hypothesis,emphasizing the influence of physical changes on individual emotions,and that emotions are a collection of somatic responses and central activity changes triggered by specific situations.In recent years,the view of embodied cognition has been highly concerned in field of cognitive science.The so-called embodiment emphasizes two points:I.cognition depends on physical experience,and the experience comes from the body that perceives movement;II.the ability of body perceiving movement in individuals is included in a broader situation involving the biology,psychology and culture[6].Some scholars put forward the view of embodied emotions,describing that emotions refer to the emotions in the whole body,including the brain.The anatomical structure,activity pattern,sensation and movement experience of the body determine the way to process emotions[7].

The above theories demonstrate that emotions are closely related to the body.Modern emotion theories promote the development of psychosomatic medicine and have guiding significance for modern diagnosis and treatment of psychosomatic diseases.

Clinical Application of Emotion Theory in Psychosomatic Medicine

Diagnosis of psychosomatic diseases

Psychosomatic diseases are a group of diseases of which the occurrence and development are closely related to psychosocial factors,but the physical symptoms are the main manifestations.In the diagnosis of clinical psychosomatic diseases,clinicians often ignore the influence of psychosocial factors on the patients,and only pay attention on the physiological pain of patients.While both TCM theory and modern psychology theory of emotion has confirmed an inseparable relationship between emotion and body.Therefore,psychosocial factors should be emphasized in the diagnosis of diseases,and the role of emotions on diseases should be especially concerned.

Treatment of psychosomatic diseases

It is notably demonstrated that,in TCM theory and modern psychology theory regarding the emotion,there is a close relationship between emotion and body.Therefore,in the treatment of psychosomatic diseases,it is recommended to heal the body through the psychological intervention.An important prerequisite for health is to deal with emotional catharsis and expression.

TCM therapy of emotion

For the treatment of psychosomatic diseases,TCM has always advocated a treatment order of first the spirit and then the body.In the occurrence and treatment of psychosomatic diseases,TCM has always regarded emotional disorders and physical diseases as a whole.TCM therapy focuses on the regulation of emotions,and clinical therapy predominantly follows the principle of the inter-restriction between emotions.The inter-restriction between emotions refers to one emotion correcting the other ill-conditioning emotion,so as to effectively correct the disease caused by the ill-conditioning emotion[8].The principle of the inter-restriction is the mutual restriction of five phases,which is mentioned in the Yellow Emperor’s Medical Canon,namely the grief restricts anger,fear restricts joy,anger restricts anxiety,joy restricts melancholy,anxiety restricts fear,indicating the interrestrictions between emotions.In the occurrence and treatment of psychosomatic diseases,TCM proposes the significance of emotional regulation,and applies the interrestriction between emotions on clinical treatment of psychosomatic medicine,thus achieving good therapeutic c effect.

Release of negative emotion

Emotions can be divided into positive and negative.Negative emotions can let the spirits droop,cause a pessimistic and negative mind,induce physical malaise and inappetence.Common negative emotions include sadness,anger,boredom,guilt and so on.To manage negative emotions,patients should be encouraged to face up to negative emotions,rather than to escape them,and release negative emotions in a reasonable way.For example,patients can listen to songs or cry a lot,so as to relieve the sadness.In the Mindpower:The Hidden Function written by Dr.Vemon Coleman,tears can reflect an emotional release,and also relax the body.Tears due to sadness can provide an important approach of pressure relief,and also help the body to eliminate harmful chemicals[9].In clinical setting,medical staff should be monitor and detect negative and pessimistic emotion of the patients,and guide them to release negative emotions reasonably.

Control of positive emotion

Studies have shown that positive emotions have a powerful effect against the diseases,and the power of positive emotions far exceeds our imagination.Common positive emotions include laugh,optimism,braveness,love and care.Even though encountering a disease,patients will obtain amazing outcome when they maintain positive and optimistic.Therefore,in clinical practice,medical staff should guide and influence patients with a positive attitude,and encourage patients to face diseases in a positive manner.

Prevention of psychosomatic diseases

For the prevention of psychosomatic diseases,TCM emphasizes the preventive treatment of disease,and proposes that a quiet,simpleminded,unsophisticated personality without strong desire may be followed by vital qi in the body flowing normally; keeping a sound mind will not cause any illness.As stated in the Plain Question Shanggu Tianzhen Chapter,it is essential to maintain a peaceful,healthy and harmonious mind; to live in a quiet,stable and regular environment.Human should maintain a comfortable and stable mood,harmonize the balance between qi and blood,nourish both body and spirit,and establish a stable psychological defense mechanism,which can ensure normal physiological function of the viscera.Modern emotion theory also emphasizes the relationship between emotion and body.Therefore,the importance of emotions should be highlighted in the propaganda of preventive measures of psychosomatic diseases.It is recommended to behave and manage affairs in a positive and optimistic manner,regulate and release emotions,thereby effectively avoiding and reducing the occurrence of psychosomatic diseases.

Summary

Psychosomatic medicine investigates the psychological and physical medical problems and targets psychosomatic diseases.It follows the principle of the unity of body and spirit.With the transformation of modern bio-psychosocial medicine model,clinical medical staff pay increasing attention on psychosocial factors,especially emotions,in the occurrence,development and outcome of diseases.In modern society,the prevalence of psychosomatic diseases is increasing year by year.According to the TCM theory and modern psychology theory regarding the emotion,emotion and body are inseparable,and changes in emotions have a great impact on the body.Guided by the emotional theory under the spirit-body relationship,clinicians pay attention on the patient’s emotions,use emotional therapy to regulate the emotions,rationally release negative emotions and control positive emotions,so as to effectively diagnose and treat psychosomatic diseases.Emotional theory has a guiding significance for modern diagnosis,treatment and prevention of psychosomatic diseases,provides new ideas for the development of clinical psychosomatic medicine,and promotes the development of psychosomatic medicine.