Palpatory Diagnosis of Emotions – TCM and Osteopathy

© Antoine Carron D.O., Nice, France ¹

Introduction

Traditional Chinese Medicine (TCM) and osteopathy share a holistic view of health, in which body, mind and emotions are interconnected.

The palpatory diagnosis of emotions is a key concept in both of these approaches, aiming to understand how overly intense emotions can manifest in the body and contribute to various physical symptoms.

Palpation is used to identify tensions, energetic blockages, and internal imbalances related to emotions.

Emotions can have an external origin, triggered by events outside the patient. However, they may also arise internally, linked to organic or visceral dysfunctions that hinder the body’s ability to process emotions effectively.

1. Emotional Foundations of Traditional Chinese Medicine (TCM): A Holistic Approach to Body and Mind

In Traditional Chinese Medicine (TCM), health is perceived as a harmonious balance between the body, mind, and energies (Qi). Emotions play a central role in this framework: they are natural reactions as well as energetic movements that directly influence the body through meridians and internal organs.

When mismanaged or repressed, these emotions can lead to imbalances, affecting both physical and mental health. [1]

Each emotion is associated with a specific organ, and these connections are reflected in the palpatory diagnosis.

2. The Importance of the Five Emotions in TCM

TCM identifies five primary emotions, each linked to a major organ. These emotions are considered as natural energetic manifestations of human existence, beneficial when they flow freely and are well-regulated. [2]

However, when an emotion becomes excessive or overly repressed, it can harm the corresponding organ:

• Anger and the Liver: Anger is associated with the Liver, which in TCM regulates the circulation of Qi throughout the body.
  This emotion corresponds to an upward surge of Qi and an increase in physiological rhythms associated with Qi flow.
  Repressed anger can result in Liver Qi stagnation, leading to heightened Qi “pressure” (frustrated elevation), manifesting itself through multiple symptoms such as headaches, pressure in the chest, neck pain, or even digestive disorders. Emotionally, poorly managed.
  Emotionally, poorly managed anger can lead to irritability, aggression, or latent frustration. Sighing becomes a clinical symptom of interest, acting as a mechanism to relieve pressure.
• Sadness and the Lungs: The Lungs are linked to sadness, sorrow and grief.
  Intense or prolonged sadness can weaken Lung energy, impairing Qi diffusion throughout the body and causing energy blockages. Symptoms may include fatigue, respiratory difficulties, or increased susceptibility to respiratory infections.
  In TCM, weakened Lung energy disrupts harmonious Qi flow, leaving the individual vulnerable to immunological issues and more prone to depression or despair.
• Fear and the Kidneys: Fear directly affects the Kidneys, considered the source of vital energy (or “Jing essence”) in the body. Kidney imbalance causes Qi to descend, potentially disrupting its flow.
  Chronic or deeply ingrained fear can weaken this essence, resulting in symptoms such as lower back pain, chronic fatigue, or urinary disorders.
  On an emotional level, Kidney imbalance can manifest as persistent fatigue, insomnia, and a heightened sense of vulnerability.
• Joy and the Heart: Joy is linked to the Heart, the organ regarded in TCM as the home of the spirit (Shen).
  Excessive joy, often related to constant excitement, substance-induced euphoria, or even euphoric shocks (e.g., winning the lottery), can disrupt Heart functions.
  As the Heart governs blood circulation, its imbalance may cause palpitations, sleep disturbances, or restlessness.
  TCM emphasizes balanced joy to nurture a serene mind while cautioning that prolonged euphoria may weaken Heart energy over time.
• Worry (Rumination) and the Spleen: The Spleen is associated with worry and rumination.
  Excessive preoccupation impacts the Spleen’s function, leading to Qi stagnation or agglomeration, which manifests as digestive issues, bloating, fatigue, and difficulties concentrating.
  In TCM, this accumulation of thoughts disrupts the Spleen’s ability to “transform” both nutrients and emotions, causing a sense of mental and physical heaviness.[3]

3. The Concept of Emotional Stagnation and Excess

In TCM, emotions are expected to flow freely throughout the body, carried by vital energy (Qi). A blockage in this energy flow can lead to physical tension, while an excess of a particular emotion can “overwhelm” the associated meridian and organ, disrupting its proper functioning. [5]

• Qi Stagnation: When Qi is obstructed in a tissue or meridian, stagnation occurs.
  For example, a person suppressing anger may impair the flow of the Liver meridian, experiencing chest tightness, shoulder stiffness, or pain in the liver area. This sensation of blockage corresponds to a circulation anomaly within the Liver’s functional territory.
  Such stagnation can be detected by the practitioner along the meridians as areas of tension or density.
• Excess Qi: If an organ is overactive, the Qi may become excessive, causing intense symptoms such as palpitations for the Heart or sharp pain for the Liver.
  This is often observed in individuals experiencing prolonged extreme emotions without an outlet for expression.
  Conversely, an intense emotion that persists too long within the tissue can also lead to a collapse of the affected organ’s functions.

4. Observing Bodily Signs and Imbalances

In TCM, diagnosing excess or deficiency is based on the observation of visible and palpable bodily signs [6] :

• The Skin: Certain areas of the body may change in color or texture depending on emotional imbalances, reflecting poor circulation within the associated meridian.
  Additionally, reflex zones of organs may become painful upon palpation (e.g., Jarricot’s dermalgia).
  Similarly, skin trophicity can be altered by organ dysfunction. For instance, a Lung dysfunction might directly affect skin health or the pathway of the corresponding meridian.
• Muscle Tension: Increased tension in specific muscles or tendinomuscular meridians (a network of muscles and fascial chains linked to a meridian) may indicate stagnant emotions.
  Since organs are connected to tendinomuscular meridians, poor Qi flow within a meridian can lead to dysfunction in the associated organ.
• Localized Pain: Localized pain can arise from two primary factors: organic pain (necessitating differential diagnosis) or functional pain.
  Organic pain is often similar in cases of functional disorders and pathology, so it is essential to master the clinical examination. For example, hypochondrium pain may occur in liver-related dysfunctions and associated emotional imbalances.
  Conversely, functional pain corresponds to pain generated as a result of poor functioning of the system. For instance, recurrent and erratic tendon pain may stem from the depletion of Liver Qi and Blood.

5. The Role of Palpation in the Assessment of Emotions

In TCM, practitioners use palpation to assess the condition of meridians and internal organs: [7]

• Meridian Palpation: Through meridian palpation, the practitioner can detect variations in temperature, texture, or sensitivity, which may indicate stagnant emotions.
  For instance, excessive heat sensation along the Liver meridian could suggest intense or repressed anger.
• Palpating dermalgias or alarm points (also known as Mù 木 points)[8] is particularly valuable. Pain in these areas helps identify hypo- or hyper-functioning of the associated organ system.
• Pulse Palpation: The pulse is a key diagnostic tool in TCM [9,10].
  Beyond measuring its frequency, practitioners assess more subtle aspects, such as depth or strength, which may reveal emotional imbalances.
  A simplified approach to Chinese sphygmology, adapted for osteopathy, could involve recognizing Yin and Yang pulses:
  • Yin Pulse: Deep – Slow – Thin – Weak
    • Indicates an emotion experienced too intensely in the past or a chronic emotion weakening the system.
  • Yang Pulse: Superficial – Rapid – Broad – Strong
    • Reflects an intense current emotion or repressed emotion from the past.

Chinese pulse diagnosis is inherently more intricate, involving six distinct positions and two depths. Each position, or “compartment,” corresponds to an organ and its paired viscera. The organ manifests at the deeper level, while the viscera are evaluated at the superficial level.

The positions are as follows:

Right side:

1. Lung / Large Intestine
2. Spleen / Stomach
3. Pericardium / Triple Burner

Left side:

1. Heart / Small Intestine
2. Liver / Gallbladder
3. Kidney / Bladder

6. The Impact of Emotions on Health According to TCM

In TCM, a persistent emotional imbalance can evolve into a tangible physical disorder, illustrating the deep connection between emotions and health. [11] [11]

Examples include:

• Chronic anger and hypertension: Regularly experiencing unexpressed anger can lead to elevated blood pressure due to the Liver Qi’s dynamic mechanics.
• Prolonged sadness and respiratory issues: Chronic sadness may weaken the Lungs, increasing susceptibility to respiratory infections.
• Emotional shock and kidney problems: An emotional shock can deplete Kidney energy, causing fatigue or pain in the lower back and knees.

The nuance in TCM lies in the fact that the same emotion, depending on its duration and intensity, may result in varying functional consequences and palpatory diagnostic findings.

7. Palpatory Diagnosis in TCM: Feeling and Understanding Emotions

Palpatory diagnosis in TCM aims to detect energy blockages and tensions associated with specific emotions.[12] [12]

Practitioners use palpation to assess the texture of tissues, temperature, and vitality of meridians.

A skilled touch can reveal signs of stagnation, deficiency (understood as insufficiency), or excess in Qi, correlating to retained emotions.

• Visceral Palpation: Organs and viscera are palpated to identify areas of sensitivity or tension.
  In osteopathic palpation, both tissue movement and quality are essential. Observing tissue traction during visceral palpation is particularly insightful.
  Qi deficiency will cause a loss of density of the matter and therefore a soft area. Conversely, an excess will cause a higher density and a feeling of refusal in palpation, the tissue will repel our touch. [13] [13]
• Neuroceptive phenomena during visceral palpation are also a strong indicator of movement and Qi quality disturbed by trauma. [14] [14]

8. Link with Osteopathy: Understanding the Physical Impact of Emotions

In osteopathy, the idea that the body “stores” emotions is accepted and integrated into practice. Emotions can cause tension in the body, particularly in connective tissue, the visceral system and the musculoskeletal system.

Through palpation, the osteopath identifies structural imbalances and areas of tension.

Osteopathic palpation enables:

• Identification of restricted areas in the body.[15] [15]
• Release of tissue tensions linked to repressed emotions.
• Restoration of mobility in body structures to eliminate stagnant energy.
• Enhancement of tissue quality and mobility within the visceral system.

9. Techniques for Emotional Release Through Palpation

The goal of emotional release through palpation is to help patients release tension associated with unresolved emotional experiences.[16] [16]

In both TCM and osteopathy, several techniques are employed:

• Gentle palpation: Encourages the soft release of tension and is often used in TCM to tonify Qi in cases of deficiency.
• Targeted pressure: Focused on affected meridians to stimulate Qi circulation, commonly used in TCM to disperse Qi in cases of excess.
• Visceral techniques to act on the organs linked to emotions, such as balancing maneuvers of the visceral system [17]. [17]
  Direct treatment of the organ is often insufficient, the organ system is the conjunction of the elements responsible for organic functions and their regulation.
  Treatment of mesosystems, nerves, arteries, joints, motility and all elements that can impact visceral functioning is also important.

10. omplementary Approach Between TCM and Osteopathy

Combining TCM and osteopathy provides a dual perspective on emotions.

Osteopathy brings a matter-based approach that helps to physically release anchored emotions, while TCM approaches emotions through the energy system and prioritizes the information contained in QI and their links to the organs.

11. Conclusion: A Therapeutic Alliance for Emotional Balance

Palpatory diagnosis of emotions is a valuable tool, revealing how emotions manifest in the body and can be addressed through gentle and respectful approaches.

By integrating TCM’s energetic assessment and osteopathy’s precise palpatory and biomechanical techniques, practitioners can profoundly address emotional imbalances to promote holistic well-being.[18] [18]

This combination offers a comprehensive, integrative approach, considering each patient as a unique blend of emotional and physical dynamics, paving the way for balanced health and renewed wellness.

Bibliography

[1] – Flaws, Bob. The Treatment of Modern Western Medical Diseases with Chinese Medicine: A Textbook & Clinical Manual. Blue Poppy Press, 2001.
[2] – Maciocia, Giovanni. The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. Churchill Livingstone, 1989.
[3] – Beinfield, Harriet, et Korngold, Efrem. Between Heaven and Earth: A Guide to Chinese Medicine. Ballantine Books, 1991.
[4] – Johnson, Jerry Alan. Chinese Medical Qigong Therapy: A Comprehensive Clinical Guide. International Institute of Medical Qigong, 2000.
[5] – Kaptchuk, Ted J. The Web That Has No Weaver: Understanding Chinese Medicine. McGraw-Hill, 2000.
[6] – Maclean, Will, et Lyttleton, Jane. Clinical Handbook of Internal Medicine: The Treatment of Disease with Traditional Chinese Medicine, Volume 1. Pangolin Press, 1998.
[7] – Flaws, Bob, et Sionneau, Philippe. The Clinical Practice of Chinese Medicine: Palpation and Its Diagnostic Significance in Chinese Medicine. Blue Poppy Press, 2001.
[8] – Deadman, Peter, Al-Khafaji, Mazin, et Baker, Kevin. A Manual of Acupuncture. Journal of Chinese Medicine Publications, 2007.
[9] – Hammer, Leon. Chinese Pulse Diagnosis: A Contemporary Approach. Eastland Press, 2001.
[10] – Marié, Éric. Le diagnostic par les pouls : Tradition et modernité. Presses Universitaires de Grenoble, 2011.
[11] – Hsu, Elisabeth. The Transmission of Chinese Medicine. Cambridge University Press, 1999.
[12] – Peck, Seth. Emotions in Traditional Chinese Medicine: A Comprehensive Guide. Lotus Publishing, 2015.
[13] – Larre, Claude, et Rochat de la Vallée, Elisabeth. The Seven Emotions: Psychology and Health in Ancient China. Monkey Press, 1997.
[14] – Porges, Stephen W. The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation. W.W. Norton & Company, 2011.
[15] – Chaitow, Leon, Palpation and Assessment Skills: Assessment and Diagnosis through Touch. Churchill Livingstone, 2010.
[16] – Legge, David. Close to the Bone: The Treatment of Musculo-skeletal Disorder with Acupuncture and Other Traditional Chinese Medicine. Eastland Press, 1990.
[17] – Barral, Jean-Pierre, et Mercier, Pierre. Visceral Manipulation. Eastland Press, 1988.
[18] – Mahoney, Patrick J. Osteopathy: Models for Diagnosis, Treatment and Practice. Elsevier, 2016.

Antoine CARRON
Osteopath D.O.
Graduate of the Institute of Traditional Chinese Medicine

1. L’ostéo4pattes-SDO would like to thank Antoine Carron for allowing us to publish his work. ↩︎