Chinese medicine and physical exercise
Lately, I’ve been considering any holes I can find in my Classical Chinese Medicine education here at NCNM. Amazingly, there aren’t many. It’s hard to put together a top notch program in any topic, much less one as complicated as Chinese medicine. One place I have found myself without much to go on is in understanding the role of physical exercise in health according to this medicine. I’ve learned things here and there, both in class and in my own study, but the information is confusing and definitely conflicts with my own experience in places. In this article, I’d like to briefly discuss what I feel I have learned and the problems I’ve found therein. I hope that you will add your input in the comments. Some of what I write below will be in explicit TCM terms, as most of the docs I’ve talked to about this subject know that system best.
What I’ve learned about physical exercise since starting school in Chinese Medicine:
- In general, vigorous exercise is not recommended. This is particularly the case when the exercise is productive of lots of sweat. The thought is that the discharge of so much sweat inevitably damages Heart Yang, given that Heart Yang is used to expel sweat from the pores. Instead, gentler forms such as Qigong, Taiji and sometimes Yoga are recommended. These are said to build the body from the inside in a way that does not damage any vital substance of the body.
- Many of our doctors mention of how overwork can be very bad for the muscles and tendons and deplete both the Blood and the Qi. This is often mentioned mostly with relation to labor, but also non-working exercise. We are frequently asked to consider the lot of laboring people worldwide. They are often physically strong, but become ill easily and have shortened life.
- Much of the negative information we get about exercise concerns specific habits. For instance, showering or soaking in water directly after being very sweaty (with open pores). It is said that this (common) practice pulls dampness into the body and creates conditions of damp and hot damp in the middle jiao. Lifting very heavy weights over long periods of time are widely regarded (by most medicine) to be difficult for the joints, tendons and even bones. Another commonly mentioned problem is the tendency for many weight lifters to be building a sort of “muscle shell” that only conceals a hollow interior. Their muscles are very strong, very impressive, but the person is ultimately weak on a number of levels.
- There are often discussions about the importance of protecting the Heart. We often hear worry about making the Heart work so hard and wasting its precious Qi and Yang. Sometimes we will discuss various spiritual theories about the length of a person’s life being determined by a pre-determined number of heartbeats or breaths. I don’t think this information is regarded very seriously, we simply discuss it as something intriguing to consider.
I can understand much of this. For instance, it is certainly important that we don’t overwork ourselves. I see many people exercising in the name of health who seem to be making gains (losing weight, gaining muscle) but possibly at the expense of their longevity because of heavy wear on the joints and Heart. Further, the practice of being hot and sweaty and immediately going into the sauna or hot shower has always made me cringe a little.
On the other hand, we need to be mindful of the current state of most Americans. Another thing that we hear railed about at school is the danger of being overweight - leading a sedentary lifestyle. So, while exercising too much is certainly a bad thing and we can advise our patients to avoid it, we do need to help our overweight and out of shape patients! It seems that most Chinese medicine doctors would have us just eat a moderate diet, sleep well and do gentle movement in order to stay healthy. This sounds fantastic, but it doesn’t seem to work for everyone. It also makes one wonder what to do with a person who comes in already suffering from an overweight condition. Often overweight conditions are helped with dampness draining formulas and SP rectification, but again, this doesn’t seem to work for everyone. Some of the work seems to need to come from the person themselves.
Anciently, of course, most people were doing hard labor. In many of the Qigong forms we use, we visualize doing various kinds of labor (grinding the millstone, for instance). So, there is obviously some kind of recognition of the physical benefit of hard work. But, again, as explained above - it’s clear to anyone that too much hard physical labor is not great for a person.
I’m interested in this topic for two reasons. First, I expect to have plenty of fitness-challenged patients walking through my door in just over a year’s time. I want to know how to talk to them in a way that makes sense, will help them understand a course of action and yet also be rooted in Classical Chinese Medical principles. Second, as part of my revised Year of Sagely Living goal, I plan to engage in a program of focused physical exercise to help achieve a more optimal physique. Why do this? Well, by anyone’s measure I do need it and also I find that the process (exercise, focusing on what’s going on with my body) is very pleasurable and gives me lots of energy in a way that doesn’t feel at all jittery or strange.
I’m interested to hear others’ thoughts and experiences with this topic. What have you learned? What have you rejected? Please comment!
Note: For the record, my current plan is to balance my physical cultivation through a combination of walking/bike-riding, weight lifting, gardening, Qigong and yoga. I am also doing some work with diet, but mostly just watching portion sizes and eating until I am about 3/4 full. This seems to work the best for me. I’ll probably track my progress on the YSL page, if you’re interested. I will be watching, particularly, my experience of some of this information listed above and monitoring my energy levels very carefully.
Eric
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Tags: exercise, human physiology, Year of Sagely LivingRelated posts
Deepest Health LIVES!
It’s true, my friends, Deepest Health is still around. It’s been a couple of weeks since I posted, but I shall fail you no more. I needed some time to rejuvenate my brain and - perhaps more than that - reevaluate why I created this blog in the first place. I spent a lot of time working on this last summer, and I think my work has paid off handsomely. But, frankly, it can get a little wearing sometimes.
The same is true of the Year of Sagely Living. I am the kind of person who seems to be able to do a whole lot without tiring. However, I can only do this if I understand on a deep level WHY I am doing it. With life getting so busy as the reality of being in the clinic and starting my own business start to set in… well, it’s easy to lose sight of why I do the things that I do. I think you can relate?
Out of this extended hiatus has come two things - both of which I would like to share. This will be followed rather shortly with a return to a semi-regular posting frequency and all the things you’ve come to love so much about this sweet little corner of the Internet.
The first thing - A VISION STATEMENT for Deepest Health
If there was ever any question that I’m a total dork, I hope this will put that question to rest. But, seriously, while the idea of having a formal mission statement may seem silly, it is a construction that helps me keep focused on my vision. Without vision, the people perish! Doubtless this vision will undergo significant evolution as time goes on. Without further ado…
Deepest Health is a place for the exchange of information and inspiration about Classical Chinese Medicine through the publishing of written, visual and audio material of value to students, practitioners and patients. Deepest Health makes no claim to have a monopoly on the truth of Chinese Medicine or medicine in general. Deepest Health, instead, encourages a warm and expansive spirit of exploration, experimentation and exhortation so as to participate in the evolution of Classical Chinese Medicine as the medical system of choice for contemporary people.
The second thing - A reorganization of the Year of Sagely Living project
I’m pretty excited about this. As April came and went (without an update from me - despite the fact that my garden is doing FABULOUSLY well) I began to rethink the whole Year of Sagely Living concept. Through conversation with my partner, Amanda Barp, and my friend Abdallah Stickley, I determined that a reorganization of the thing could be quite rejuvenating. First, let me share some of the reasoning before explaining what I will be doing from now on. I’ll try to keep it simple.
Initially, the idea for the YSL came from conversations between Dr. Stickley and myself about how self-cultivation seems to be the very essence of what it is to be a Classical Chinese physician. We both have particular traditions of practice (or amalgams of traditions, in my case) that we feel are in some harmony with the principles of self-cultivation that the Classics discuss. In essence, we wondered if our cultivation practices would be similarly productive of great physicians. This led to further conversation about the types of cultivation exercises that seem embedded in the theory and practice of Chinese medicine. Eventually we began to talk about the organ clock and how it might be a helpful organizational tool for a program of CCM centered self-cultivation. Thus, the YSL was born.
But I have noticed a few problems with the original format. First, we switch too often. While there is some continuity between months, mostly they represent very different categories of practice. I could spend a year simply on the excellent practice of raising my own food, delving deeply into it, learning from it… The same is true of all the categories. The second problem is that somehow the categories and their practices were feeling like an extra veneer I was placing on my life - not as something being deeply embedded in me in the sense I expected. I expect this has something to do with the character of my own situation, but it failed to meet my desire for the project. Third, more nebulously, somehow the project as described and practiced so far doesn’t speak to the initial impulse behind the whole thing. It’s wonderful how it’s gone and I appreciate very much everyone’s participation - but I’d like to see it evolve.
While the conversations between Abdallah and I have not (and probably never will) come to some “final” or “static” conclusion, I feel that my mind is settled with regards to the topic. We batted several ideas around. One was to create a YSL focused on scholarship - twelve months of different scholarly topics (Yin/Yang theory, Five element theory, etc). An incredible idea - but not appealing to the overworked student in me. Perhaps after I graduate? Another idea was to halve the number of categories and double the time spent in each. Good, but perhaps not solving the root. There are two “winning” ideas that I’d like to see others play with.
First, one would become more serious about one’s own personal practice. For instance, a practicing Zen Buddhist might renew his or her dedication to that practice. He or she would then use that practice as a lens through which to look at Classical Chinese medical theory and practice. For instance, consider the practice of meditation. How does diving deeply into a meditative state enhance or hinder the practice of Chinese medicine? How can we characterize meditation from the perspective of CM theory? How does quieting the mind in this way develop one as a physician? What do the Classics seem to say about this kind of activity? What is the experience of the practitioner or practitioner in training? In this way, we come to bring our deepest selves fully into our practice of Chinese medicine. Does that sound fun or what? In many ways, Abdallah exemplifies this kind of work in many of his blog posts and, indeed, in the whole concept behind his blog.
Second - the choice I will be working with - requires that we artificially cleave the calendar year into two parts, yin and yang. It would be easy to get bogged down in discussing various theories about which months are Yin and which are Yang, but I’d like to make this as easy as possible. Because of the time, I’m going to say that April began the Yang phase and it will consume April, May, June, July, August and September. Then we will enter the Yin phase of the year until the following April. Feel free to divide where you like. Then take just ONE category of practice behind the YSL. I will be choosing that of my physical body, energy and vitality. Use the entire year to focus on this category, altering the precise habitual expression of the category as necessary to match the seasonal energy and one’s own situation. For instance, in the more “Yang” time of the year I plan to focus on the relatively more Yang aspects of physical activity, moving Qigong forms, intellectual assessment of the physical body, etc… In the Yin part of the year, perhaps I will focus more on developing stillness, balance and thorough nutrition. Does this make sense?
I’m anxious to hear folks’ thoughts. Please chime in and feel free to adapt any and all of the ideas above for your own practice. I believe moving into this kind of YSL idea will help me to produce more posts about it, as I will be diving more deeply into it.
Thanks for reading - more soon,
Eric
Tags: Blogging, inspiration, vision, Year of Sagely LivingRelated posts
How would a sage care for the planet?
April has already begun and I’ve spent quite a bit of time thinking about the habit I would like to develop in pursuit of a more sagely existence. First, let’s recap what was said in the inaugural Year of Sagely Living post:
April - Large Intestine, Mao 卯 (Rabbit) - Care of the planet/consumption: This category will contain practices that develop us into compassionate and sane consumers, while helping to develop our deep relationship with the natural world. Why this pairing? April is a time when we can see the beauty of nature all around us, so is a great time to contemplate our dependence on it and responsibility towards it. Also, the negative side of LI/Rabbit is a tendency to run rough-shod over the needs and wants of others, these practices will seek to counterbalance this.
My lifestyle is already very much concerned with what I would call “compassionate consumerism,” which is to say that I consider the human and non-human ramifications of my actions every time I buy, consume or discard something. I recycle about 20 times more than I throw away, my version of whole-foods veganism lives lightly on the planet, I use my own two feet and public transportation most of the time, so on and so forth. Looking for a way to leave the planet in better shape than I found it has been a sort of part-time job of mine. So, figuring out an excellent practice for April’s Year of Sagely Living both had more weight and seemed more challenging.
At the end of March, I really took some time to review the whole Year of Sagely Living project. I have a passion for personal development, and my thoughts and actions naturally tend in this direction. However, “regular” personal development is not what my schooling, future career, and this blog are really about! The point is to look at categories of practice that seem to be aligned with the essence of Chinese medical philosophy, live by them, and analyze the results. The hypothesis is that these practices, particularly when they are very deeply rooted in Chinese medical philosophy, will be productive of excellent human beings. What I’m getting to here is that I want to be sure that I stay connected to the aim of reaching back to the ancient wisdom.
So, when considering my April YSL goal, I really tried to consider what kind of practice I could do that would bring me in line with the overall aim of the project. I’ve decided, with my family, to try to grow as much of our produce as possible in our backyard. I have been trying for a long time to develop the habit of growing food. We have beautiful houseplants and have managed to grow some excellent flowers, shrubs and trees in our yard. We have several fruit trees, raspberry bushes, and now a strawberry patch. We have had a container garden on our back stoop for two years running that was mildly successful. Now we have the space and the desire to really make a push and create a beautiful, bountiful space to provide our fruit and vegetable needs and we should use it.
This goal is ideal in a number of respects. First, it really brings us into line with our desire to buy the majority of our food locally. We shop at our local coop which has this goal as one of its goals, so we generally eat food that comes from pretty close to home. However, growing it in our yard would take that to another level. Eating locally is one of the greatest things you can do to reduce your environmental impact, as it reduces theamounto of petroleum used to get you the things you eat. It has a number of residual benefits as well, such as strengthening the local economy. We are making an attempt to make this even more petroleum-neutral by using public transportation when we can to get things for our garden, sharing some supplies (and their transportation) with a garden-savvy friend, etc…
Another reason why this goal is ideal for the YSL is that it connects the two vital practices of interacting with nature and ensuring the viability of our ecosphere. Chinese medicine has nature observation and contemplation at its root. Watching the cycle of growth, death, and rebirth will certainly deepen my understanding of this root. Third, there are a number of health benefits involved in growing a significant portion of our food. Micro-agriculture seems to yield more Qi-laden veggies, having lots of veggies around will promote us to eat them more often and the work itself (when done mindfully) can be tremendously good exercise. Finally, I really believe that interacting with nature on this level will confer some spiritual benefits - improving my general level of personal cultivation.
Some details:
- We will be growing the following: two kinds of kale, two kinds of chard, two kinds of lettuce, lots of tomatoes, potatoes, broccoli, summer squash, delicata squash, cucumbers, spicy peppers, chicory, carrots, fennel, basil, oregano and maybe a couple of other herbs. I will be seeking out Chinese herbs to grow as well. I know our local Classical Chinese Garden sometimes has plant sales.
- We will be using all organic soil amendments and pest control.
- We will not be using any machines in creation of the garden.
- We will be using heirloom varieties whenever possible, open pollinated.
- We will be using raised beds created from recycled wood (left in our yard by the landlord) or FCS certified wood
I will discuss the particulars of my experience and probably even find a way to post pictures of the garden as it grows. This will obviously be more than a month, but I will use my Year of Sagely Living intensity to really engage in the process of setting up the garden and getting it in the ground and then do periodic reports as time goes on. I can’t wait to hear about other people’s April Year of Sagely Living goals!
Eric
Tags: chinese-herb, chinese-herbs, environment, environmentalism, garden, habits, nature, organic, Personal Development, Year of Sagely LivingRelated posts
Learning how to keep life in balance
It’s time for my March Year of Sagely Living update! I believe that my efforts were successful, overall. My true goal this month was two-fold. First, I wanted to pay close attention to the two hour time periods associated with each organ system on the Chinese medicine organ clock. Second, I wanted to create and maintain space for my family and myself amid the festering chaos of medical school.
Attempting to pay attention to the times associated with the organ clock was more difficult than it may sound. I found that I looked at the clock and really paid attention at the same times each day. This was usually around mealtimes, when I had a natural break in my work cycle. Regardless, it was valuable to take a few minutes to really absorb the energy of those times. Interestingly, I noticed that my ability to clearly take in the energy of the “day time” organ systems became stronger as the sun became stronger. I also found that my ability to access the energy of each organ system was easier during the period associated with that organ system. I tested this by doing meditations on organ systems during other than their associated times.
I noticed how attempting to align my daily activities with the various organ system times yielded some appreciable benefit. For instance, eating breakfast closer to “Stomach time” (7-9am) definitely yielded less indigestion given the same meal than eating breakfast closer to “Heart time” (11am - 1pm) or even earlier during “Lung time” (3-5am). I also noticed that the general cycle of the 12 organ systems and their associated time made a lot of sense and following this flow more often than not created a harmonious feeling within me. By the end of March (aside from some rocky times during Finals week) I had settled into the following pattern (taken and edited from my journal notes):
- Waking up and doing breathing exercises doing Lung time (3-5 am) considerably easier than any other time, yields greater benefit in energy through the day. I always found that taking a nice walk, alone and in a natural area, yielded a lot of intuitive insight and positive emotional breakthroughs.
- Going to the bathroom between 5 and 7am (Large Intestine time) seems easier, more complete and now that I do this I find that I have far fewer digestive problems overall - all things being equal. Maybe a funny thing to point out, but important from a medical standpoint.
- Eating as close as possible to 8 am (in the 7-9am period, Stomach time) seems to yield relatively few digestive problems through the day. You can see above for more explanation.
- Avoiding too much exercise during the 9-11am time frame (Spleen time) seems to enhance my digestion. I like to spend this time doing more “passive” work like reading, easy writing projects and hanging out in the back yard. When I have to go to a difficult class during this time, I invariably have indigestion.
- Heart time (11am-1pm) is especially well used doing work that connects firmly to my purpose. I find that if I do creative writing projects, formulas study and conscious business development during this time I get really good work done. Much harder to do anything else like eating, doing menial work, heavy physical activity, etc…
- 1-3pm is a great time for more menial or “have to” projects. I connected this with the Small Intestine’s function as the fu organ of the Heart - it transmits the vision and purpose of the Heart which is best expressed through SACRIFICE. Perhaps most interestingly, I found this to be the best time for lunch. When I eat closer to noon, it tends to upset my digestion.
- 3-5pm was a little difficult to nail down. In my journal I have listed the following observations: good time for spiritual activity like prayer and devotional reading, best time for just sitting with family, excellent period for a daily review. In the end, I think that Bladder time is best for more “visioning” activities, taking a larger view of my life and embracing that aspect of daily living.
- Kidney time 5-7pm seems best suited for evening walks and deep relaxation. For instance, Qigong during Kidney time seems to be particularly fruitful - which is a surprise. I’ve always done my Qigong in the morning.
- 7-9pm, Pericardium time, is absolutely beautiful for sharing a meal with my family and really nourishing my connection with them. This was the best family time and I experienced no trouble with digestion as long as I ate by 9pm. After 9pm, I just wasn’t hungry.
- Triple burner time, from 9-11pm, is when I must go to bed. If I stay up much into Gallbladder time, I’m in trouble - when it gets to be about midnight, I’m usually up until 3 or so. I just can’t settle down. I think this makes a lot of sense given the mysterious Triple Burner network, the organ system of dreams, of in-betweens and of delving deeply into the Yin.
- I didn’t have much experience of either Gall Bladder or Liver time, although I did have a stretch of insomnia that would have me waking smack dab in the middle of the two (always right around 1:30am) needing desperately to go for a walk or eat something terribly bad for me. :)
All of this being said, I’m not entirely sure how I feel these two hour periods should be viewed and used. I can’t say that the experience was so profound that I would want to live my life aligning my activities closely with them. It’s also quite difficult for me to do as little work as the organ system cycle seems to demand. But it did remind me that I need to make sure to take time for myself and for my family. It also made me much more intense about continuing to wake up around 5am to do walking and breathing. SUCH a benefit - I can recommend it to absolutely everyone. But there was, for me, clear benefit in the exercise. Overall, I think a few basic lessons were learned by engaging in this habit during the month of March:
- The general progression is valuable to experience.
- Great alterations away from the basic progression usually yields feelings of dis-ease.
- For the purpose of understanding organ systems, spending time observing nature or human society during key periods is very instructive.
- I think that further research could be helpful, especially in terms of learning more about chrono-acupuncture.
- It may be that like everything, there are acceptable individual variations from the norm that are still supportive of health. However, straying far from the basics is probably never healthy.
The other major goal, making sure to leave weekends open for my family and myself, was the most wonderful part of March’s Year of Sagely Living activity. I was very good at keeping this time open, even when I had a lot of very pressing work to do. I would frequently do work on Saturday mornings, but often it was in tandem with my partner. I can’t tell you what this did for my psyche. Even though my finals week was extremely difficult, I was able to weather it and did wonderfully well on my tests. I felt that I integrated a lot more of what I was learning and feel more open to the lessons of next term even though we only get a week off. I am going to continue this habit because it was so powerful.
I think that this is one of the most potent lessons we can teach our future (and current) patients - our culture asks us to be “on” ALL the time. We are told that if we aren’t willing to “go hard” we should “go home.” I do believe in the immense power of hard work and I believe that many people are working far below their capacity. However, it is an absolute MUST to leave time to reconnect with the source of your personal power. This means your friends and family, visioning your personal and professional life and simply having time to relax in your garden or go for leisurely walks. While these activities don’t pay much per hour and they can often be VERY hard to justify in a maelstrom of work commitments, they are what ultimately pays the greatest dividends.
Coming next, my commitment for the month of April. Stay tuned and thanks for reading.
Eric
Tags: activity, Acupuncture, balance, chinese-organ-clock, Organ systems, organ-clock, rest, Year of Sagely LivingRelated posts
Why I am about to become slave to the clock
As I described in my last post on the Year of Sagely Living, March is meant to have us focus on the balance of rest and activity in our lives. I’ve thought more about this category than the two prior, because nothing immediately sprang to mind as a perfect practice to undertake. This is especially true because I am attempting to maintain my January and February practices and having some success with both of them.
Ultimately, because I’m trying to stay as focused on explicit Chinese Medicine material as possible, I think I’m going to focus on the organ clock. It’s such a ubiquitous part of our lives at school, we talk about it in almost every class. Some laughingly shrug it off, others take it seriously but don’t seem to evaluate it much. I’d like to use March as a kind of organ clock laboratory. Using Brandon Brown’s widget to help me keep to the true organ system periods, I will be doing a brief (3-5 minute) meditation on the organ systems as the energy reaches its peak within each. This will require me to be vigilant in watching the clock, which shouldn’t be too much of a problem because of the relatively regimented quality of my normal schedule.
There are some caveats. Obviously, sometimes I will be in class when I should be doing a meditation. I won’t be able to do each organ system every day. Over the course of March, however, I should get a good sense of the reality of the organ clock at each position. Another problem is that I will be sleeping during a portion of the organ system times. I considered having a weekend where I set an alarm for each organ system during the night to get a sense of their qualities. However, because we have finals coming as well as our clinical entrance exams, I don’t think that’s a fantastic idea. The most yin of the organ systems are going to have to wait to be tested.
Along with this, I will continue to maintain my practice of leaving Sunday completely open for family time - rest and relaxation. Saturday is also a family/home day, but I let myself do some work-related things such as my Weekly Review. I have already seen such great benefit from doing this, I can’t think of any reason not to continue.
One final goal, and I’m afraid this is a bit of a doozy. The “one goal at a time” advocates will not be happy with my do-it-all approach. :) Starting tomorrow, I will begin weaning myself until I reach a solid habit of waking at 5am. The early morning time is my very favorite and while I currently wake around 6, I don’t feel that it is early enough. I would like to take that early morning time to recharge myself in a variety of ways - through brisk walks through the neighborhood, Yijing readings, tea on the deck, Qigong, meditation or any other quiet activity that fits well with the gentle early morning energy. I have lots of help on how to achieve this goal - many bloggers have written about it. Steve Pavlina is one of my favorites as far as this topic is concerned.
So, to recap - my March Year of Sagely Living practices are:
1. Organ clock meditations during the peaks of the energy for each organ system.
2. Continuing my practice of spending weekends on family/home oriented rest and relaxation.
3. Going through the process to achieve the goal of waking at 5am daily - including weekends.
Thanks for listening.
Eric
Tags: balance, meditation, organ system, Organ systems, personal commitment, Personal Development, relaxation, Year of Sagely Living
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