The Transformative Role of East Asian Medicine & Acupuncture in Palliative and End of Life Care
Previously published in the 2022 issue of The Journal of Acupuncture and Integrative Medicine
An undeniable reality of working with cancer patients is that some patients will not survive their diagnosis. Chinese medicine and acupuncture has the ability to significantly improve the quality of life of terminal patients. Many barriers exist that block the use and acceptance of acupuncture as a tool for end of life care, including lack of awareness of the modality, funding and insurance coverage. In addition to the ability to treat side effects of medication and disease along with the pain associated with death, acupuncture helps reduce anxiety, stress and helps patients find peace in the dying process. As practitioners working with patients with potentially terminal diseases, it is critical to place focus on our ability to hold space for the healing process through death as it is for the healing process through the curing of disease.
An undeniable reality of working with cancer patients is that some patients will not survive their diagnosis. The role of Chinese medicine and acupuncture in palliative and end of life care is by no means as researched or studied as the care and treatment of disease and illnesses like cancer, but it’s role is powerful, impactful and has the ability to significantly improve the quality of life of terminal patients up until their transition. Many barriers exist that block the use and acceptance of acupuncture as a beneficial tool for end of life care, including lack of awareness of the modality, funding and insurance coverage. In addition to the ability to treat side effects of medication and disease along with the pain associated with death, acupuncture is an excellent modality to help patients reduce anxiety, stress and find peace in the dying process, to ultimately, die a good death. Inherent within acupuncture elemental theory is the process of the transition from birth to death and the cycle of life, associated emotional states and opportunity for healing. By deepening our understanding of the connection this medicine has with not only the physical body but the mind and spirit we have a unique opportunity to help our patients not only experience relief of pain and suffering, but also an impactful and meaningful transition. As practitioners of acupuncture and Chinese medicine working with patients with potentially terminal diseases, it is just as critical to place focus on our ability to hold space for the healing process through death as it is for the healing process through the curing of disease.
Every time something awful happens in the world, it makes its way into my clinic. This week Roe v Wade was overturned and it’s been the topic of every patient’s mind and heart. I often hear the words ‘you’re not my therapist but….’ while my patients explain to me their emotional or spiritual troubles. This happens so often that it’s now one of the main things I treat in my clinic - emotional pain, upset and trauma, and it’s also why I’ve become a transformational Jungian Life Coach, so that I can truly help you in the entire process of body, mind and spirit. You might think heading to an acupuncturist to deal with your break up doesn’t make a lot of sense, but the truth is, emotional pain goes far beyond just the mind, it affects our body and our spirit, and Chinese medicine is especially equipped to bridge between these three aspects of our lives: body - mind - spirit. Feelings are called feelings for a reason - they are literally felt in the body, actual sensations that we feel caused by neurotransmitters, hormones and enzymes - it can be tingling, numbness, tension, heat, the list goes on, but every time we have an emotional reaction, before it came a physical reaction. The world we currently live in is rife with reasons to be upset - wars that are never ending, political upheaval, an economic system on the brink of collapse, domestic terrorism, pain and strife is parmount every time we turn on the television or open up TikTok, and that doesn’t even include our personal life’s ups and downs.
It’s incredibly important that during times of stress, change or upset we find support, you may get that from friends and family, a therapist, the gym, and yes, an acupuncturist. Body work can be profound to help the mental and emotional healing process. We have to help the body process and move the energy (and neurotransmitters, hormones and enzymes) that is associated with emotional responses so that we can feel clear and like ourselves again, so that we can move forward and make choices out of response instead of reaction. If you’re still wondering ‘how on earth can acupuncture really help me with my emotions?’ let’s dive right in…
Maybe the Instagram or Tiktok algorithm has been sneakily suggesting it’s time for you to look at your shadow self by showing you posts about shadow work, or more likely, you’ve been noticing that life feels extra difficult lately - haven’t we all! Perhaps most things in your life are going pretty ok, you may have even gone to some therapy before and are making progress on becoming your best self, but something still isn’t quite right. When things start feeling stuck or prickly in a sort of abstract way, it might be time to look into shadow work.
Shadow work is an essential aspect to your individuation process. Individuation is the amalgamation of all of the facets of who you are so that you can show up as your divine true authentic nature in the world and all things. The shadow self isn’t a ‘bad’ or ‘evil’ part of you, rather it’s the qualities and aspects of yourself that at one point in your life, likely early childhood, your ego needed to hide in order for you to survive and fit in. Later in our lives we may notice similar negative patterns or relationships repeating, feeling very triggered or judgmental around certain people or events, struggling with impostor syndrome, or just feeling like something is ‘off’ or missing in our lives, these are all signs that a part of our shadow is coming up to be integrated. Let’s take a deeper look at some of the signs you might be encountering that are signs it’s time for shadow work.
Having anxiety can be a debilitating experience, it can come on out of nowhere, but even when we have awareness of the triggers, it can still catch us off guard, stop us in our tracks and really put a halt to anything we wanted to do. Having tools and coping mechanisms to help guide us through an anxiety or panic attack can be crucial to our ability to feel like we can release the anxiety and live our lives. While medications can be extremely helpful, they also come with side effects and can cause considerable drowsiness which isn’t always desirable. I’ve found acupuncture treatments on a regular basis to be particularly powerful for helping my patients move through anxiety, stress and other tough emotions. But if you aren’t near your Acupuncturist’s office the following acupressure points can help you become more grounded, present and calm in a matter of minutes.
I recommend you go through all of the points mentioned here, treat one side then the other and use the treatment time as a time to slow down, to gather your thoughts and release them as you move through the protocol. You may notice you start yawning, or your eyes water, maybe even cry a bit - these are all good signs that your body is releasing that energy and emotion which will allow you to carry on in a more calm space when you are finished.
While my clinic is not seeing active COVID-19 patients in person, one demographic we’ve been seeing and having a lot of success with have been COVID long haulers. A ‘COVID long hauler’, ‘long COVID’ or ‘chronic COVID’ is when symptoms persist beyond the active infection time, these symptoms can persist for weeks to months and risk for long term permanent effects seems to be likely. This presentation has been likened to Lyme’s Disease in that the precipitating factor is a viral infection followed by a chronic presentation of symptoms that range in severity from mild to severely disabling.
Long COVID patients are typically burdened with shortness of breath, difficulty with exertion, dizziness, fatigue that can be extreme, continuation of loss of smell and taste, brain fog and much more. It’s a disheartening condition to watch, because of so many unknown factors there isn’t a lot of help from modern medicine and many patients are simply told to wait it out. Patients go from active healthy individuals to barely being able to get out of bed, this type of condition takes its toll not only on the body but particularly the mind, emotions and spirit. Our work with Long Haulers is to help encourage healing in the body, benefit the Qi - the vital life force of the patient and help patients find their center again in the midst of sometimes devastating circumstances. By helping bring peace and hope back into the healing process we have seen many patients make great strides in their healing.
Women’s health, fertility and conception are some of the concerns that my patients will come in for, I think this aspect of acupuncture and herbal medicine is actually a bit more well known, second to pain treatments, and there’s a reason for this: it works. If you were ever a fan of the HBO show Sex and the City you might remember Charlotte’s experience with Dr Mao the acupuncturist who helped her learn how to tune back into her inner peace and eventually get pregnant for the first time. This side of acupuncture often gets talked about in a kind of whimsical miraculous type of way, where people hear about one person who had success and tout acupuncture as the ‘miracle cure’ for all fertility woes. And while yes, for some people acupuncture might just be the missing link to having a healthy happy baby, it’s often a piece of a multi-pronged approach. We’ve seen through scientific study that acupuncture improves the success of IVF treatments, so it’s not just an old wives tale, it really does work.
Where my work comes with fertility patients is less focused on direct hormone and menstrual cycle support, although this is definitely a part of the treatment protocol, but more focused on what we think in Chinese medicine as ‘cultivating the baby’s first home.’ The womb and the mother are essentially your baby’s first home, and we need to make this place a calm, nourishing, warm and supportive environment for the baby to thrive and develop in before birth. Part of this often revolves around cultivating new stress management practices, accessing our inner peace and learning how to truly listen to our body. If our outer world is highly stressed, our body also takes on this energy and it can make a pregnancy become difficult, particularly if we are wanting to call in an intentional pregnancy.
The Branch, Root and the Soil - A Chinese Medicine Perspective on Pandemic Denial and Anger
We live in a world where, for all of our lives - beauty and status have been paramount: we crave it, we seek it, we spend our extra money on attaining it, seek out jobs that can provide for it, it’s ‘necessary’ for assimilating into social culture or being ‘seen’ … It. Is. So. Important. But… is it?
When we first experienced our ‘lockdown’ in the Spring I was aghast at the level of denial and flat out refusal of some people to follow safety guidelines. It made no sense… Why are people so readily willing to throw common sense out the window for a haircut? Are eyelash extensions really that important? Who benefits from outright denying this pandemic actually exists? Why is there so much hostility over a tiny piece of fabric? As time has passed the deniers and rebels against protocols became louder and more polarized, likely due to the politicization of the entire process. And while doing a little self-care to pump up our self esteem and confidence is an absolutely valid process, it always seemed like something much, much deeper was at play.
In Chinese medicine one of the first diagnostic principles we learn is to differentiate the root from the branch. The branch might be the presenting symptoms a patient walks in with, knee pain, insomnia, headaches, stress, anxiety, you name it - it’s the first thing that the patient complains about when you ask what they would like to work on today. The root is that underlying cause that created the environment for the current symptoms to arise in the first place. We often think of this as a constitutional imbalance, meaning that everyone has their own predisposed weaknesses and strengths, perhaps this is passed on from our parents and ancestors, maybe a result of early childhood illness or trauma or other underlying issues. The root is often extremely complex, and can sometimes be difficult to diagnose, but once we can get to it, or pointed in the right direction we often will see transformative shifts occur in the patient. The knee pain that hardly responded to direct treatment now can begin to release because we’ve found the root of the issue in a deficiency of the Water element and Kidneys due to some repressed fear. As we begin to unpack this root cause, the physical or emotional symptoms start to give way to the healing that is present. I also like to look another step deeper, to the soil, this is the deepest layer, this unseen and usually unnameable force that sets us up to create and experience certain things in our lives, perhaps another name for this is fate or predisposition. Dr David Hawkins, PhD calls it the ‘attractor pattern’, it’s the unseeable pattern that sets up the visible and nameable string of events that eventually leads to the presentation we are looking at in our office.
How’s life going for you?
Do you feel like something is missing? A lack of inspiration perhaps? Feeling closed off from others or even yourself? A sense of despair or an absence of the ‘heart and soul’ of life? Maybe you’ve been having trouble sleeping? Feeling anxious? Restless? Difficulty concentrating?
If this sounds a little too familiar read on… it might be a disruption or disturbance of your Shen.
Let me explain…
In traditional Chinese medicine (TCM) the way we look at our mental, emotional and spiritual health is by looking at the Five Spirits - these spirits are aspects of our complete animation as a human on Earth from our Divine spiritual nature to our animal instincts to the connection with the collective unconscious. These spirits all serve different aspects of the self and our interaction and experience on Earth, as such we can address issues that arise in the psyche by addressing these spirits. As goes with all illness and disorder in TCM these issues with the spirits can be experienced in a range of severity and intensity and also duration - meaning we can have a mild and brief Shen disturbance that lasts a day or two or we can have a more severe and chronic presentation that lasts for months, years or a lifetime, there are many causes and reasons why which I’ll get into later on.
I love chocolate, I just… love it; it’s delicious, it’s gorgeous, it’s fun to work with and create from, it makes you feel good, what’s not to love? As an artist I also love working with chocolate as a medium - there is so much more than just the visual nature of it - there’s the art of flavors and combinations of textures, it’s a full spectrum sensory experience if you ask me, and this is just a part of why I love it. As an Acupuncturist and Doctor of Acupuncture and Chinese Medicine I also know that chocolate isn’t only a love affair for the senses either, it actually has some medicinal and therapeutic qualities that can help balance and nourish the body and mind. In Chinese Medicine we think of all food as medicine, all foods have certain properties and qualities that affect the body in specific ways, when we bring more awareness to these properties we can turn our entire diet into a nourishing experience directed at what parts of us need direct healing. It’s this love affair with chocolate and Chinese medicine that brought me to the intersection of combining the two - making high quality chocolates that are flavored to work with the spirit, elements and organs of the body.
Embody Compassion, Neutrality and Self Awareness in Uncertain Times
Part of life is that we are always going to experience a certain amount of uncertainty, unknowns and great changes - we’re currently having an increased experience of this right now - and it brings up a lot of heightened emotions - like fear, anxiety, worry, stress, anger and grief. It’s important to remember that all of these emotions are completely normal to be experiencing, and by processing them personally we actually help the collective consciousness move through them as well.
It’s when we get stuck in these emotions - where we chew on them over and over and get stuck, where they start to take us away from being present in our lives.
When we aren’t present we tend to experience increased amounts of these emotions but we also have difficulty making clear decisions, focusing on daily tasks and our relationships with our family, friends and ourselves tend to suffer.
Paths to Presence is a brief but in depth dive into different avenues we can take to be more present in our lives - through increased self awareness, embodying compassion and having more neutrality we can experience more peace, ease and grace no matter what we’re facing.
This self guided course offers guided meditations, short exercises and transformational tools to help you cultivate each aspect of presence that you can implement into your daily life and reclaim your personal power!
I'm excited for you to take this next step on your journey!
*PS: This course is donation based! Please feel free to use the discount code that reflects what you are able to afford*
Dr. Kim Peirano, DACM, LAc is the Owner and Acupuncturist at Lion's Heart Wellness, the San Francisco Bay Area and Marin's #1 Cosmetic Acupuncturist and #1 Holistic Healer.
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