I. The generation of psychosomatic diseases
Everyone will get sick in their life, and when they look into the reasons, they always use the old saying “people eat grains and cereals, which does not get sick” to comfort themselves. In fact, many diseases are related to psychological factors, but not to diet. Why is that?
From the point of view of the causes, most diseases are psychologically related, including AIDS; if a patient has some psychological stress, his condition will deteriorate more quickly. Studies have shown that 80% of all diseases are psychologically related and that psychological factors play a major role in the development and healing process of diseases. In particular, psychological problems play a major role in some diseases, including ulcer disease, colitis, hyperthyroidism, diabetes, rheumatoid arthritis, hypertension and bronchial asthma.
1.What is psychosomatic disease
Psychosomatic diseases refer to the diseases caused by the main role of psychological factors. Now there is the concept of subhealth, subhealth refers to a state of mind and body. When modern medicine talks about a disease, it refers to its pathological changes and changes in the structure of the material hierarchy. Another kind of change is when we feel subjectively very uncomfortable, but go to the hospital and nothing can be detected. Now we can judge that this is called subhealth, i.e. psychosomatic disorder which means that there is some dissonance in both psychological and physical levels. When people have psychosomatic disorders, not only psychological and physiological problems, but also adaptive problems, and even interpersonal relationships can be affected. If we get used to this pathological state in our daily life, we will not feel it.
2.The main causes of psychosomatic diseases
The main cause of psychosomatic diseases is the unique psychological problems of human beings, such as morality, dignity, social norms and values, which are actually related to culture. We are all born into many boxes as children, and there are many boxes that exist when we go to school and work every day. Many times we can only adapt ourselves to these boxes and break through; if we don’t, we may have big problems of our own.
For example, the lecture now puts me under pressure for only two hours, and I can recover quickly after the two hours are over. If a person is always in a highly reactive state, he or she may develop psychosomatic disorders. For example, when negotiating, there is an increase in breathing, heart rate, and blood pressure, which is called a stress state. If this stimulus is too strong, lasting a month, two months or even three years and five years, the situation will slowly transform into a psychosomatic disorder stage, and then more serious to develop psychosomatic disease.
3.Somatization
The next step is to introduce the very important concept of somatization. Usually when we feel uncomfortable, our first reaction may be something wrong with our body, some people may go online to find some information to read; after a while if it is still bad, we will go to take medicine; if it is bad again, we may go to the hospital for examination. This is a very inertial way of thinking. When there is any problem in the body, we think from the perspective of physical problems and seldom relate to our psychological factors.
▼Case 1
In 1997, when I was studying with my mentor in Tianjin, I came across this case of a 17-year-old girl who was preparing for her college entrance exams, and her mother brought her to see a doctor. She had been sick for seven months and had been off school for three months. When the mother and daughter came, I felt that the mother was very nervous and the girl was also very nervous and a little depressed. They brought a lot of test reports and after we read this test report we knew what kind of process she was going through. At first she had trouble sleeping and panicking because she was stressed. This girl was introverted, not very talkative or athletic, and did not have many friends. Her mother is a very controlling or over-controlling person with a strong sense of subjectivity, and her mother’s anxiety may have been there for years.
When the girl began to appear unwell, her mother became anxious and took the child for a simple ECG, which turned out to be nothing wrong, and the doctor prescribed some medication to eat for two weeks, suggesting that the problem be rechecked. Two weeks later the girl’s condition did not ease and she went back to see the doctor, who suggested she go to the local city hospital for an echocardiogram. After doing so, the chief physician thought her heart was fine and suggested that she go to the Tianjin Chest Hospital for a checkup. At this point they were already scared, and the doctor at the chest hospital checked that there was no problem, and after the expert consultation guessed that it might be a very rare congenital heart malformation, and that the current highly sophisticated examination method was to use an endoscope inserted through the thigh vein into the patient’s heart to check.
At this time the mother and the child became even more frightened, and then they found us here, when we were called the Department of Psychosomatic Medicine. The girl seemed to be in a state of anxiety, so we gave her the anxiety scale. After the examination, we told her that instead of treating her physically, she should be treated as a functional neurological disorder. After more than two months of treatment, the girl was cured. This is the case for about 40% of our patients in our clinic.
Case 2
When I first arrived in Shanghai two years ago, the owner of a nightclub ranked among Shanghai’s top nightclubs was doing particularly well, and he also came to see a doctor. He was having heart trouble and was panicking like crazy. After spending more than 20,000 yuan in some hospital for examination and two months of treatment without improvement, he came over and spent a month to be cured. In fact, I did not give him long-term medication, just told him not to drink, turn off the phone and go for a walk in the park. Most importantly, I told him, “You’ve had all the tests, don’t treat it as a heart attack, but let your tension relax.”
When we are under severe mental stress, there is a mechanism between the body and the mind that transfers the stress to the body, a phenomenon we call somatization. The most common are pains for which no cause can be found, such as migraines, menstrual cramps and gastrointestinal pain, many of which are psychological in origin, and many chest pains as well as heartburn are also due to this.
Psychologically, if a person is psychologically stressed, he is actually stressed in life, he has a problem adapting to society as a whole, and he has to deal with the problem of how to adapt better to life. If we spend too much energy on treating physical symptoms, we are going into the wrong direction. The biggest problem is that we waste a lot of resources, both social resources and our own energy and time.
I am an amateur in management, yet I know that if there is a problem that is not adjusted from within, not adjusted from the market and customer needs, and too much energy is spent on training, management, and regulation, we just end up wasting everyone’s resources and taking the whole business in a wrong direction. Again, first find out whether it is a physical problem or a psychological problem, which is the first factor.
4, the relationship between disease and personality
Type A personality is the first one that is found to be related to disease, which is a milestone discovery. Type B personality is the opposite of Type A personality, which is relatively depressed, and people with this personality are prone to diabetes.
Typical cases of psychosomatic diseases
1.Heart disease
In September 2005, I met a patient in Jingkang Health Management Center. He was a little bit heavy when he came in, a little bit fat and fatigued, had some problems with urination, and his blood pressure was high and low, but his ECG was basically normal. He had a very strong personality and was very tall, so I felt pressured to sit in front of him. He is very successful in his career, he has several companies, also does hotel management, and has a good relationship with all walks of life. He has a somewhat charismatic personality and likes to help, but he got involved in a lawsuit for helping. He is also a very hard-working person, and at that time, he came to me to see a doctor and said it was subhealth conditioning.
After a month, I once felt he was not right when I saw him and suggested he get an EKG. The test results showed some myocardial ischemia and changes in certain T segments. As a result, I learned that he was involved in a lawsuit.
I still treated him with acupuncture for the next three months, but I felt it was a failed treatment. Because I was going back to Beijing once a month, during the week I was back there, he was hospitalized with a very serious heart attack and he was very scared. I had actually explained to him that his condition was serious before he had the attack, but he was too busy with work to take a break.
He had to stop working and turn off his cell phone after he was hospitalized. After his condition stabilized, he went to live abroad for a while and then returned to normal. This is a typical example of stress coronary heart disease, and there are especially many similar patients.
2.Gastric ulcer
Generally speaking, people who are thinner and cleaner are more sensitive, and people with very high sensitivity are more responsive to stress. Many girls in stressful times will stomach pain and do not want to eat, in fact, this is a psychological problem. If you don’t know, you are likely to go for a gastroscopy or do treatment as a stomach problem, which is a wrong direction.
There was a woman who had a stomach ulcer surgery and her daughter was very anxious. Because her daughter had spent some time in a psychiatric hospital when she was young, she never fully recovered. When she was affected by living with her daughter, she had stomach pains, and later went to the hospital and found out that she had a stomach ulcer. This was also a psychological onset. After she had the ulcer, she was given the wrong treatment, and the doctor actually said to cut off the ulcer part. She didn’t understand, so she had a third of her stomach cut off in a confused manner. Her stomach did not heal for seven months after the incision, and she was re-examined five times during these seven months.
When she came to us, she was unable to sleep or eat, she was very thin and felt hopeless, so she also had a nervous breakdown. This treatment was more complicated. The first step was to eliminate her stressors. Her stressor was her daughter, and we suggested her daughter to come over and do acupuncture together (acupuncture has a good relaxing effect) and take some herbs in order to repair the gastric mucosa. Her daughter’s problems were mainly child-related, and the child’s problems were related to the teacher. The teacher is an anxious teacher who puts pressure on the students, and when the child comes back she passes the pressure on to her mother, who passes it on to her grandmother. Our society is a chain of interrelated interpersonal relationships, and no one interrupts the chain in the middle.
In this case, the most important thing was to give psychotherapy to both of them; the second thing was to let the mother do taijiquan every day (taijiquan has good relaxing and calming effects), once a day for 15 minutes at first; then twice a day for half an hour; and at the best, three times a day. After two months, Mom could eat, and I suggested she start with rice soup. After four months, she was a bit more energetic and wanted to go out for a walk, which was actually a sign of life recovery. We suggested her to go out after the visit, and when she came back, she regained her confidence. The patient’s confidence is very important in the medical process. It is important to give confidence properly, to remove the confusion and tell her/him the real situation.
This woman had a gastroscopy in April of this year and the results showed that her gastric mucosa was restored. It is important to consider psychological issues during the treatment and even more so during the onset of the disease.
The first kind of medical treatment process is that the more you look at the patient, the more scared and confused you are, the more advice you get, the more diagnosis you get, the more tests you get, and the more medicine you use, but the patient’s heart is getting more and more panicked, and this kind of treatment process is problematic. This way, the patient’s mind can be settled, which is more important for the overall recovery.
In addition, the patient’s friends and family must take care to help the patient stabilize emotionally. For example, we are responsible for the bad psychological transmission chain mentioned above. Are we able to slowly stabilize her oscillations which are very powerful? Can this stick come to you to be transformed a little better? Can we transform this stick and then go out? This is very important and everyone is closely related.
3. Stomach and intestinal tract dysfunction
Another patient of mine had constipation and back pain and spent 60,000 yuan on tests in a year and a half and still couldn’t find the cause of the attack. At that time, he underwent a functional medicine examination at Jingkang, and the metabolic value of adrenaline in his blood accurately showed that his stress level was very high, and the functional medicine doctor recommended him to see a psychologist and a Chinese medicine doctor. It was only during that examination that he realized that his illness was related to psychological stress. Before that, he first saw a doctor in Shanghai, then drove to Suzhou every week, and Nanjing, and had a colonoscopy, but no problems were found.
When a patient has done various tests and cannot find the cause and is afraid, he tends to think in a bad way. This is when he needs to be told that he should think about psychological problems. If he is very nervous, it is very important to let him relax slowly first. Don’t let him endlessly pursue the most advanced tests, looking for famous doctors, specialists and imported drugs, which is a wrong direction. A wrong direction is most troublesome in the first month and second month of the disease.
After entering the wrong direction, the patient will get worse and worse. Originally, it may be just some heartburn, but after a year or two of treatment, it really becomes coronary heart disease. What was just a temporary increase in blood sugar or blood pressure may turn out to be diabetes and hypertension.
My blood pressure is definitely higher than usual in my current state, and my heartbeat is faster than usual because I am in a state of stress and excitement. If I go to the hospital immediately after the lecture, it is likely that the doctor will consider my high blood pressure as hypertension, and I may need to take medication for the rest of my life. Cure in this way for one year, two years, three years, and finally is sure to be this disease. So always be careful of the wrong direction!
This patient was coming to see me for the first time, and when he sat in front of me the first, second, and third time, his hands were shaking, his face was red, and he was sweating all the time. I needed to settle his mind first and told him: so many test results proved that there was nothing wrong with his intestines and no other possibility of cancer, but his stress index was high and it was a psychogenic disease. I prescribed him some medications to reduce stress, then gave him acupuncture and suggested him to do exercises.
Exercise is important, and it is important to exercise when you have a physical problem related to psychology; exercise frees us from a bad state. The state of the body is important, the state of functioning of the muscle determines the state of the disease. It’s like managing a problem in management and finding out how it works from that problem. Exercise is one of the best ways to change a bad state.
This patient later recovered, he was not sick, if he made up his mind to take a month off, he would probably get better naturally. The doctor in this case only plays an auxiliary role in guiding the direction. The role of medicine is not to check and prescribe more drugs, but to mobilize the body’s own resources to make it work better, which is the role medicine should play.
4.Diabetes
The patient worked in a state-owned enterprise and was a stable section-level cadre for more than twenty years. Later, when the enterprise was restructured, his cadre position was no longer available and he was only paid basic living expenses every month. He was a man of good looks, and usually had a good personality, relatively good face, and did not like to confide, and entered such a bad state that his blood sugar became high within a month. He felt uncomfortable, could not sleep, no energy, panic, did not want to eat. He went to the hospital for blood test, urine test and ultrasound, and the result was high blood sugar and diagnosed as diabetes. He was hospitalized for a month and a half with fluids and medication, but his blood sugar did not come down and he felt something was wrong, so he came to us to see a doctor.
After understanding his situation, I suggested him to try other treatments, otherwise he would definitely be diabetic with the current treatment. His current state is just a temporary elevation of blood sugar, just like the 9/11 emergency state in the U.S. It was also very strong then, and now it is slowly stabilizing. If counter-terrorism is excessive the country will definitely go wrong, and so will the person. I suggested that he continue to take the medication, and then run 40 minutes every day, insist on boxing, and soak his feet every day. The patient came back ten days later to pick up the blood sugar dropped a little, he was very happy, I suggested that he continue to run, continue to take the medication, watch less TV at night, go to bed at 10:30, and do what he likes to do every day. After another week, his blood sugar dropped a little bit, I suggested him to reduce his western medicine a little bit and measure his blood sugar and urine sugar every three days. After one month, his western medicine was almost reduced, and after three months, he stopped all his Chinese medicine and western medicine and just ran. Now four years have passed and he is in good shape and has no diabetes.
Diabetes, hypertension, hyperlipidemia, the most important treatment for these three diseases is exercise – exercise, sleep early, relax mentally, the most wrong direction is to take pills, pills, pills! This is like a business funding problems, to maximize the mobilization of internal possible potential, rather than immediately go to the loan, to find a godsend to solve the problem.
5, hyperthyroidism
Hyperthyroidism is also a very common psychosomatic disease. Hyperthyroidism generally has several tests, let the patient stretch his hand flat, flat stretch after putting a piece of paper, if that hand thumping, it means the body is very nervous. Some hyperthyroid patients have protruding eyes, red face, sweating, fast heartbeat, eat a lot, and cannot sleep, and are generally very thin at first. What I just described is like the overheated state of a fast developing economy: high input, high output, but no accumulation.
I met several patients with hyperthyroidism, and I was impressed by a woman who worked for a general company. The woman who came with her to see the doctor made a remark that struck me: she said that people who could stay in GM were soldiers. Another patient, a director of the Diaoyutai State Guesthouse, had been suffering from hyperthyroidism for two years and had been seen in the United States and the United Kingdom, as well as by Chinese doctors. I think her illness may only be cured by leaving the post because it was so tense there, and they had to make proper arrangements in all aspects before the leaders came. She has to make phone calls, make personal inspections, and every point has to be implemented without the slightest error. If the leader stays until midnight, she also has to stay until midnight; after the leader leaves and makes sure there are no more problems, she dares to sleep and sleeps with her phone on, always in a state of stress. It is impossible for her to recover from hyperthyroidism under such circumstances. This patient is, first of all, hypersensitive, very, very sensitive.
In the past few years, we called many of the current diseases “modern diseases”. Modern diseases are mainly lifestyle diseases, stress diseases, and psychosomatic diseases, which we call changes in the disease spectrum. In the past, people got sick either by falling off the wagon, or being bitten by some animal, or by malnutrition, accidental injury, plague, smallpox, infection, and so on. But with the development of social and economic development and modern medicine, this part of the disease is no longer the main problem threatening human health.
To use an analogy, the psychological structure is actually our system, our program, and our lifestyle is actually our way of functioning. If we have a bad inner program and a bad way of functioning, then such a functioning will definitely go wrong, just sooner or later. This is what we really have to pay attention to, not just that we see a disease and then set an indicator for that disease, do a test on the patient and then draw a conclusion, which is called labeling in cognitive science. Labeling is meaningless.
6. Menorrhagia and dysmenorrhea
Again, speaking of amenorrhea and dysmenorrhea. Women themselves are more sensitive and a little more affected by psycho-physical factors. Nowadays, the treatment about these two diseases is mainly with hormones or herbs, both of which are effective. My advice is: if the patient is introverted, more sensitive, think more and not too good-tempered, when the tension is tighter, the energy can’t get out and can’t get down, after relaxing the symptoms will be much better.
I have talked to some friends who have been doctors for a long time, and most of them think that it is time to reflect on the meaning of illness. It’s not that if there is a problem in the body and we take care of it, it’s not relevant to us anymore. It is very important to treat these signals not by silencing them or suppressing them, but by understanding how we function through disease and then treating them at the source.
The process of treating the disease should be a model of self-communication, learning and development, and not a dangerous way of dealing with the patient who gives himself to the doctor without doing anything. We should know ourselves, understand ourselves and change ourselves through our disease: change our character, change our life.
Because when we have a very serious disease, basically the same as when a computer goes wrong, it must have been used too long, there are too many holes inside the program, or too little memory, or too many files that have not been processed, so it has to shut down: to be sick is to shut down. For the computer, there is no need for everyone to be their own programmer, but through the opportunity to learn through illness, to develop their own program to find the right direction in order to re-integrate the body and mind, but everyone must do the homework, because this is no one else can replace.
III. How to cope with stress
▼Traditional Methods
What I recommend are traditional methods such as meditation, Tai Chi, stances, yoga, etc., which can take us to a deeper level. The general stuff is on the surface level, which is called the behavior and speech level, and the deeper level is the emotional and conscious feeling level.
For example, if I ask you what you thought about this thing and what you did about that thing, at that point we are just in a general relationship; if you tell me you were sad that day, then our relationship goes to the next level, and that might describe the difference between the surface level and the deeper level. We can self-observe how much time we spend on the surface and how much time we spend on the deep side every day.
Personally, I mainly use meditation to increase my stability.
Meditation is a great way to do this, as is taijiquan, or practicing calligraphy. Something beautiful can increase our stability.
▼Helping Others and Opening Yourself Up
In recent years, I often go out and do things that are not related to my work, slowly trying to interact with people and do things that are useful to others. In this process, I seem to be slowly opening myself up.
Last year, I met a teacher who helped me a lot. One time we were talking and I said I was a “patient” myself, but I was still seeing other patients every day, which was interesting. He told me that helping others was helping myself, and that if you communicate with others in an “open” state, you will truly heal yourself. That teacher also often gives lectures, and he said a very classic sentence: when you heal others, you are actually healing yourself.
If a friend who has had a long history of trouble with family members or colleagues can do things with a helpful and healing approach, then untying that knot is actually untying your own knot.
Generally speaking, people with stronger egos and more boxes need to try to open them.
▼Movement
When I encounter a very angry person in my clinic, I usually take the approach of first suggesting that the person take up yoga or tai chi. After he has stabilized, I will take him to meditate. For people who are mentally weak, I suggest doing some strong exercises.
If anyone here has a small child, or a friend has a small child, if this small child is timid, sensitive and prone to crying, you can suggest him to do very good exercises or practice martial arts, the better exercises or martial arts can strengthen one’s spiritual power.
People with high stability are very simple, no matter how the emotional scales shake, just put him in a stable place and don’t touch him, he will stabilize himself, this is also the principle of meditation. When a person with low stability meditates, it is best not to turn on the cell phone or telephone, and sit quietly for 30 minutes, after a while it will be much better.
If a person is unstable, it is better to learn tai chi, meditation or yoga, or use any suitable way to make yourself stable. The other indicators among the five latitudes are not a big problem if they are high or low, but a big problem if they are unstable. The Central Committee of the Party puts forward “stability first, development is the hard truth”, which is the truth.