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Braden
10-27-2002, 01:09 AM
Does anyone have any experience/knowledge of chinese medical approaches, traditional and modern, to treating mental illness (particularly schizophrenia and other psychoses)? Is it approached from the same standpoint as general chinese medical theory? Are there preferred treatment modalities? Have the chinese integrated western psychiatry/neurology into their practices? Are there any education centers for this field in north america, or other useful resouces you can recommend?

Basically looking for general information. Sincere thanks.

Former castleva
10-27-2002, 06:26 AM
A good Q.

Well Iīd like to know more too but I know that internal diseases and things like mental ilnesses are also treated with basical TCM,including acupuncture etc.
I know TCM has itīs alternative own stand on this,if we pick depression as an example.
You could say that it is caused by blocked emotions etc. and call it TCM and then you could also say it is a yang condition and related to certain such organs etc...

Thatīs about all I know so far.

Repulsive Monkey
10-27-2002, 10:55 AM
One of the main treatments used in this area is a procedure in Acupuncture referred to as Internal and External Dragons.
It is also used for compulsions obsessions, posessions and heavy mental/psychotic behaviour.
I have witnessed a transformation of someone who was heavily psychotic and delussional in a short period of time become exceedingly weel adjusted and balanced mentally.

ZIM
10-27-2002, 10:07 PM
2 links to look at:

check here (http://www.acos.org/)
(to maybe write to a clinician?)

& especially here (http://www.todoinstitute.org/)
(For recent Japanese approaches)

TCM Not so good for schizophrenia, in general, but I think there were studies relaying that, basically, non-western countries havce a better record for treating schizophrenics, if using recidivism as a yardstick, not length of treatment time (check book _Mad_in-America_) possibly becuz less meds are used.

Studies & cuts:

1. J. Leff, "The International Pilot Study of Schizophrenia: five-year follow-up findings," Psychological Medicine, 22 (1992), 131-145.

The first World Health Organization study that compared schizophrenia outcomes in "developed" and "developing" countries was called The International Pilot Study of Schizophrenia. It began in 1968, and involved 1202 patients in nine countries. At both two-year and five-year follow-ups, the patients in the poor countries were doing much better. The researchers concluded that schizophrenia patients in the poor countries "had a considerably better course and outcome than (patients) in developed countries. This remained true whether clinical outcomes, social outcomes, or a combination of the two was considered." Two-thirds of the patients in India and Nigeria were asymptomatic at the end of five years. The WHO investigators, however, were unable to identify a variable that explained this notable difference in outcomes.

2. Assen Jablensky, "Schizophrenia: manifestations, incidence and course in different cultures, A World Health Organization ten-country study," Psychological Medicine, suppl. 20 (1992), 1-95.

The second WHO organization study of this type was called the Determinants of Outcome of Severe Mental Disorders. It involved 1379 patients from 10 countries, and was designed as a follow-up study to the International Pilot Study of Schizophrenia. The patients in this study were first-episode patients, and 86% had been ill fewer than 12 months. This study confirmed the findings of the first: two-year outcomes were much better for the patients in the poor countries. In broad terms, 37 percent of the patients in the poor countries (India, Nigeria and Colombia) had a single psychotic episode and then fully recovered; another 26.7% of the patients in the poor countries had two or more psychotic episodes but still were in "complete remission" at the end of the two years. In other words, 63.7% of the patients in the poor countries were doing fairly well at the end of two years. In contrast, only 36.9% of the patients in the U.S. and six other developed countries were doing fairly well at the end of two years. The researchers concluded that "being in a developed country was a strong predictor of not attaining a complete remission."

Although the WHO researchers didn't identify a variable that would explain this difference in outcomes, they did note that in the developing countries, only 15.9% of patients were continuously maintained on neuroleptics, compared to 61% of patients in the U.S. and other developed countries. This difference in outcomes is also consistent with research in the U.S. showing that neuroleptics induce brain changes that make people more biologically prone to psychosis. One would expect that drugs that induced such changes would lead to increased chronic illness, and the failure of most patients to attain a complete remission.

3. At the same time that the WHO was reporting on poor outcomes in developed countries, Harvard Medical School researchers published a study concluding that outcomes for schizophrenia patients in the U.S. had declined since the 1970s, to the point they were no better than they had been in 1900. They found that since 1986, only 36.4% of patients in the U.S. have had favorable outcomes (or were "improved" during a follow-up period that averaged 5.6 years.) See J.D. Hegarty, "One hundred years of schizophrenia: a meta-analysis of the outcome literature," American Journal of Psychiatry, 151 (1994), 1409-1416. (The Harvard researchers did not blame neuroleptic use for the poor outcomes; on the contrary, they argued that despite the poor outcomes in the modern era, neuroleptics still should be seen as beneficial.)

link for mad in america (http://www.madinamerica.com/) if you want to read som of it. interesting.

:)

Repulsive Monkey
10-28-2002, 03:36 AM
I would have to disagree because I have seen first sucesses with TCM on patients with mental health problems, and I have seen documentation done in Chinese hospitals showing vary favourable results. It is of course not the only form of treatment for it that does well, but it is certainly worth investigating.

ZIM
10-28-2002, 09:41 AM
RM-
Not really disagreeing with u, but I do have to split hairs here and note some history.

Diagnosis in TCM is very different so its difficult to say whether whats being treated is 'schizophrenia' or not. Schizophrenia itself may very well be a cluster of related disorders as well. That said I do agree that TCM can and does make inroads to Tx.

History: China itself is communist. While that shouldn't affect medical issues that fact is that it does and that makes research suspect. China inherited the foibles of Soviet psychiatry IMO and uses incarceration and Tx for political reasons. This makes advances beyond TCM (i mean modernizations, diagnostic advances and such) very hard to find. So I wonder whether any research from china itself is solid and whether TCM people elsewhere handle these disorders. Perhaps those in Taiwan??

The category psychosis itself gasined currency at the same time that China embraced communism as well, and the culture is different enough to influence its appearance. There are, I note, also culture-specific mental illnesses which TCM does treat.

I have not seen any TCM for this firsthand, so I bow to your understandings first. Respect to you. :)

Repulsive Monkey
10-29-2002, 08:32 AM
Thanks for your reply but some of what you say seems wafully biased towards the politics of China having a slant on the medical results. I won't deny that but by and large it is negligible to say the least. Conditions of Schizophrenia are naturally referred to as something else in chinese medicine because the word is not chinese yet the symptoms were recognised in chinese medicine way before they were properly clarified in western medicine. One could then say that it is the term schizophrenia from the west which is the more dubious description maybe?
TCM and its older branches have a history going way back with good treatment for mental diseases and its study and research into a lot of it predating trials held in Europe and America.
The chinese were doing some pretty advanced treatment with mental illnesses when all us lot were back in the medieval times.

However I do respect your post and I will try and dig some documentation up and get it printed out on here.

Braden
10-29-2002, 10:29 AM
RM - Could I recommend a book to you? The Healing Hand by Guido Majno.

http://www.amazon.com/exec/obidos/tg/detail/-/0674383311/qid=1035915828/sr=8-1/ref=sr_8_1/103-9080212-3527849?v=glance&n=507846

Many cultures, including those the West considers their ancestors, have a rich and sophisicated history of medical practice - this is not only the domain of the chinese. It is en vogue in many circles to consider the west young and classically ignorant, just as it's common among others to consider traditional chinese methods hysterical and unsubstantiated. Both beliefs are unfortunate preconceptions which can cause alot of wisdom to be lost.

A truly stunning passage in the above book describes retinal reattachment surgery in classic Greece, for example.

ZIM
10-29-2002, 04:43 PM
Oh yes. The original Dementia Praecox as identified by Bleuler [?maybe he was first to coin the word/differentiate it from DP?] in Germany may very well have been a contagion from horses, so the story goes. Appaerently the population of his clients could be split to those who were infected with that and those who had the real thing as we now know it. The definition has thuis changed for what schizophrenia is, actually. Even the brain centers most involved in it have shifted location over time! heh

Further we can get into the whole question of whether or not the declaration of a disease entity promotes the nosology. This is curious, in that schizophrenia is a really modern illness. Before this you were just 'mad', but there were far fewer madmen, it seems, back then. societal Intolerance, perhaps? or a reframing of the question of madness?

As i said previously there is some debate as to whether or not the entity 'schizophrenia' is a cluster of related syndromes/illnesses. There are at least 5 varieties with various ways of showing themselves, some expressive some not at all. Curious. Thomas Szasz believed that it was more a 'problem in living' than a discrete disease, in that no organic brain damage was evident, yet the medications can and did cause brain changes. (Szaszs stuff is on the net, BTW)

Recent advances seem to point towards random misreplication of genetic material as the culprit, as if a certain percentage must be reached to achieve psychosis. Tempting but not proven yet. Anyhow that is all western aspects.

TCM I think has many bold ways of helping the afflicted with these disorders. the 'problem in living' approach in a sense, if we can view it in the sense of readjustment to bodily harmony.

Braden: only a comment on the west/east 'divide' perception. We forget too readily that the West is at once both very ancient and very young, mostly because we had our great industrial revolution that changed everything (tho some say it was neither industrial nor a revolution...but i'm vonnegut's love child, so i digress). We also forget to honor it- there is nobility and spirit in it, IMHO.

It seems that you got your answers too: approached from basically the same standpoint, preferred is acupuncture herbs, some counseling, holistic approach? The buddhist ways are very good for it too, i think, even here in the benighted west. The chinese have integrated some not all western neurology and psychiatry into their medical establishments, but also include some soviet and other countries' contributions (a wider palette then). Some political issues are involved (maybe overstated- we tend to hear much more about abuses, naturaly). There are some schools too, and i've given one. some more are in vancouver oregon, seattle, out that way.

Oh yes i forgot- politics does influence our [western] Tx as well, certainly and that taints results too we must own up to that. A quick look at Foucault can point that out superbly. Anyhow if the west science way has any strength it is a willingness to abandon its own BS if it finds it is BS, when its at its best. I hope to see much more acceptance of TCM [and MCM?] here in the west.

just rambling away..:D

Jack Squat
10-31-2002, 12:54 PM
Hello everyone.

For more info on this subject, I suggest that all those who are interested should go to www.chinesemedicalpsychiatry.com or to www.bluepoppy.com.

Have fun.

Jack

ZIM
10-31-2002, 01:54 PM
You know, I HAD seen blue poppy before....Thanks for the reminder!

Braden
10-31-2002, 07:54 PM
Jack - Thanks for the links.

Guohen - I think you're confusing a couple distinct movements. Freud and his followers largely argued vehemently against chemical restraints and institutionalization.

guohuen
11-01-2002, 07:40 AM
Sorry I wasn't clear. What I was trying to say was that since Frued was popular and German, anything German became the thing to do. The nazis first institutionalized the mentally ill and handicapped, then started the wholesale murder of them. Over 150,000 mentally ill and handicapped people were murdered by the nazis before they started on anyone else.

ZIM
11-01-2002, 12:47 PM
True- this was the order that the Nazis did follow, but it is also true that 'our' (by which I mean, the USAs) Eugenics movement predated the Nazi one, and that they'd toured the US to learn 'better' methods in treatment for the 'mentally defectives'. We'd passed laws (by supreme ciourt ruling) in favor of forced sterilizations, forfieture of property and denial of suffrage. We still have a number of iffy things on the books, re: limiting of civil rights, enforced medications, etc. No easy answers, like for most things. Still, you're not wrong! The german thing was popular.

Just really saying that we're all still trying to find a good & just way. :( Braden is correct to point out that Freud & co. is a different (and notably jewish-originated) movement. Two 'germanic' movements existed though- one psychoanalytic, one psychiatric & medications/surgery/ECT based. Both were/are a kind of hiatus, from the purist pychology POV, IMO. (But what do i know?)

I find it promising to pursue & open up alternative approaches in care and treatment, provided we can all be tolerant/open-minded here in the west. The biggest problem we face is not laws or public opinion, IMHO, but the insurance lobby....
;)

Kevin Wallbridge
11-05-2002, 03:57 PM
The discipline of Qing-Zhi-Bing/Disorders of the emotions and will, is actually quite complete in Chinese medicine. There are aspects of it which caused some concern to atheistic and scientifically minded elements of the Post-Revolutionary government that actually created what we know of as TCM. These aspects, that had to do with Shen/spirit, where actively ignored when TCM was quantified 50 years ago. They are still found within classical teaching however.

GeneChing
11-06-2002, 09:15 AM
I do Crisis Intervention for the Haight Ashbury Free Medical Clinic's special division, Rock Medicine. (http://www.rockmed.org/spaceten.htm ) I specialize in dealing with intense psychedelic reations (bad drug trips) and a few years back we experimented with acupuncture, mainly auricular. Of course, TCM has no specific advice for someone on a bad acid trip, but using metaphors to psychosis, some protocols were developed. We had to stop because it walked a fine line in the law. Acupuncture is invasive since it breaks the skin barrier and you need some sort of permission to do that, which your not going to get from someone tripping on acid (actually you might but it would be valid.) It was a shame, because we were having some success with it.

guohuen
11-07-2002, 09:33 AM
Thanks Kevin and Gene. I had no idea that knowledge was left out in the quantification of TCM.
Gene. You should write a paper. That's valuable experience and information.

Braden
11-18-2002, 06:08 PM
Kevin: Thanks for the information. Am I correct in concluding Qing Zhi Bing describes diagnostic criteria based on clinical interview and observations, with acupunture and moxibustion being the treatment modality of choice?

I noticed it's on the ACOS curriculum. One more allure to beautiful Nelson.