Philip A.M. Rogers MRCVS

AP and the Psyche


Eichelberger_B01 (1996) The Five Phases of personal evolution: Part 1. Adapted from WWW ( [Bruce Eichelberger MTOM OMD (China), LAc DiplAc (NCCA) has been practicing Qigong and Taoist healing arts for >25 yr. He also teaches classes in Personal Evolution, healing arts and Qigong, including "The 5 Movements of Personal Evolution," and "Dancing with Chaos" (c) 1995 Bruce Eichelberger All rights reserved: WebMaster].

No species or idea survives for long unless it is fundamentally sound and able to adapt to its ever-changing environment. The 5000 yr-old TCM concepts of the Wu-Xing (Five Phases) continue their usefulness to this day. The Five Phases of Personal Evolution is a model for human evolution based the structure and processes of the ancient Elemental Five Phases. It combines with these concepts aspects of the Native American Warrior's Path, NLP (Neuro-Linguistic Programming) and Qigong energy cultivation movements. This synthesis, originally refined during a 3-yr period through an advanced Taoist Nei Gong exercise called the 5 Dragons, represents a further evolution of the classical Five Phases.

Below is a skeletal representation of the Five Phase Personal Evolution Model. Each phase as well as each interaction in this model matches major aspects of the traditional Five Phases.

Phase Correspondences.
Each phase correspondence can be understood in positive, process- oriented terms reflecting the "ideal" attributes of each. These ideal states are guidelines or objectives for balanced and integrated functioning. They also reflect the relationships and interactions between phases.

Fire (HT and Shen-Spirit): Fire corresponds with Opening: unconditional giving, responding to events with spontaneous resiliency and adaptability. Our ability to show compassion, experience joy, and share with others resides here, as does the aliveness in our eyes. Fire pathology shows as being too open-hearted (to the point of self-detriment), little or no sense of limits or boundaries in interpersonal relations, inability to give emotionally or to be spontaneous.

Earth (SP and Yi-Mind): Earth is associated with Connecting: patience, being in the moment, focusing thoughtful attention and making useful mental associations. It is also the ability to be clearly in the moment. Patience, stability, home, service and tasting Life belong here. Earth pathology manifests as obsessiveness, inability to be in the moment, acting in a scattered or distracted way (not present), lack of awareness of surroundings, or difficulty moving (feeling and being "stuck").

Metal (LU and P'o-Corporeal Soul): Metal reflects Releasing: stepping back from an experience to evaluate and sort it out, refining goals and directions and the ability to let go of excessive emotional attachments to people and events. Inspiration, acknowledging self and others and refining one's character all show up here. Metal pathology is characterized by, chronic grieving & sadness, aloofness, obsessiveness, living in the past or extreme attachments.

Water (KI and Zhi-Will): Water relates to Aligning: setting foundations, maintaining integrity & balance, gathering energies, and storing reserves. It is the ability to keep rooted even in the face of chaos. It may be thought of as a rudder in the flow of life. Sometimes we must enter the Unknown and must allow Life to guide us without preconceptions, judgements or panic; Aligning is our optimal response. Water pathology might show up as lack of direction, not completing things, extremism, fear, or fixation on only one way of doing things.

Wood (LV and Hun-Heavenly Soul): Wood is expressed in Trusting. Specifically this means trusting in God, Universal Flow, Great Spirit etc. Focusing intent, doing your best and transcending limitations, both inwardly and outwardly, all correspond to this phase. This is where we reach out into new territory, express creativity and focus our intention. Wood pathology might show up as timidness, depression, being overly cautious, lack of focus, "running on empty," impulsiveness, etc.

The process interactions.
Five Phase Sheng (Nourishing) and Ko (Control) interactions are summarised as:




	Wood-LV					Earth-SP

	Hun-Heavenly Soul			Yi-Mind

	Trusting				Connecting


			Water-KI		Metal-LU

			Zhi-Will	 	P'o-Corporeal Soul

			Aligning		Releasing

Opening (Fire): is supported by Trusting (Wood); is controlled by (excess is prevented by) Aligning (Water); controls (limits detachment of) Releasing (Metal) and supports Connecting (Earth).

Connecting (Earth): is supported by Opening (Fire); is controlled by (excess is prevented by) Trusting (Wood); controls (prevents Stasis of) Aligning (Water) and supports Releasing (being present to release past) (Metal).

Releasing (Metal): is supported by Connecting (Earth) (releasing the past); is controlled by Opening (Fire); controls (tempers impulsiveness by) Trusting (Wood) and supports (with Will) Aligning (Water).

Aligning (Water): is supported by Releasing (Metal); is controlled by (keeps it current) Connecting (Earth); controls (keeps balance of) Opening (Fire) and supports (is foundation for further growth of) Trusting (Wood).

Trusting (Wood): is supported by (is founded on) Aligning (Water); is controlled by (allows for focus of) Releasing (Metal); controls (contains) Connecting (Earth) and supports Opening (Fire).

Applications of the Five Phases.
Any comprehensive, self-contained, homeostatic system has so many possible permutations that it is difficult to fully describe them. Here are three examples of these ideas:

Eichelberger_B02 (1996) The Five Phases of personal evolution: Part 2.

Example 1: An aspect of Releasing is the quality of detachment. Healthy detachment is prevented from becoming excessive by keeping a sense of openness and adaptability (Releasing controlled by Opening). Similarly, since attachments are typically a function of past/future associations, a healthy releasing of such attachments is supported by being in the present (Connecting).

Example 2: Aligning is also to a large extent the act of balancing and harmonizing all aspects of a situation. Since life is a flow of Qi (energy), a static balance is not healthy. Therefore balance must be an on-going process and is prevented from Stasis by:
1. Providing the basis for new expansion (Aligning supports Trusting) and;
2. Staying in the ever-changing flow of the present moment (Aligning controlled by Connecting).

Example 3: Each Phase is healthiest when supporting its Son Phase in the Sheng (Nourishing) Cycle and simultaneously when exerting control (applying limits) on its Grand-Son Phase in the Ko (Controlling) Cycle. Trusting, as aspect of which is going beyond limitations, functions best when it can temper the tendency of Connecting to stay exclusively in the moment. Planning (another aspect of Trusting, e.g. going beyond the limited perception of the immediate here and now), when done appropriately, tempers any tendency for imbalanced indulgence by Connecting to be only in the here & now, and stimulates Qi to move-on to Releasing where it can evaluate what is most important in the experience.

Effective use.
The important question is, "How can this information be put to effective use?" Most essentially it is a tool for self-examination and personal evolution. The concepts are exceptional as a basis for meditation or incorporation into other yogic, meditative and/or affirmation practices. Qigong exercises, which accompany these concepts, integrate them at a deep cellular-energy level, aiding in fuller understanding.

Working with others the Five Phases may be used as a basis for evaluating personality traits and tendencies and, in the context of a complete holistic treatment, appropriate counterbalancing and supporting affirmations might be assigned, or suggestions given to the patient to enhance, at the level of the patient's beliefs, the idea of total balance, thus contributing to the overall effectiveness of treatment.

In the world at large these concepts have historically been used for everything from planting crops and family interactions to running Govts and businesses. Embodying the Five Phases as a tool for personal evolution is limited only by your imagination.

Rakovic_D (1991) Neural networks, brainwaves, and ionic structures: AP v altered states of consciousness. AETRIJ 16(3-4):89-99. Faculty of Electrical Engineering, Univ of Belgrade, Yugoslavia.It is shown that neural networks with embedded "brainwaves" can cross the gap between the fast parallel unconscious mode of neuroscience and the slow serial conscious mode of psychol. The electromagnetic (EM) component of ultra low frequency (ULF) "brainwaves" appears to enable perfect fitting with narrowed limits of conscious capacity in normal awake states and very extended limits in altered states of consciousness - due to the biophysical relativistic mechanism of dilated subjective time base. An additional complex low-dielectric (epsilon r circa 1) structure is also necessary in these processes. This structure can be related to a displaced (from the body) part of AP ionic system which can conduct ULF brainwave currents circa 10(-7) A, inside the conductive Channels of the initial ionic concentration circa 10(-15) cm-3, with a tendency of deterioration during a period of circa 1 h. It provides an extraordinary biophysical basis for traditional psychology, including transpersonal experiences down to the ultimate state of thoughtless consciousness. Notions, such as "Qi", "subtle body", and "causal body", are physically inevitably associated with ions, displaced (from the body) part of AP ionic structure, and in it embedded an EM component of ULF brainwaves, respectively.

Rampes_H; Davidson JR (1996) EAP: A novel treatment for anxiety disorder. Adapted from WWW. Copyright Psychiatry On-Line 1996 (15.09.96, Version 1.00). Hagen Rampes, Senior Registrar, Barnet Psychiatric Unit, Barnet General Hospital, Wellhouse Lane, Barnet, Herts, EN5 3DJ, UK; Jonathan R T Davidson, Professor, Dept of Psychiatry & Behavioural Sci, Duke Univ Med Centre, Durham, North Carolina 27710, USA. Form and CGI Copyright 1996 Priory Lodge Education Ltd. Summary: A 33-yr old female who suffered from a generalised anxiety disorder was treated successfully with EAP. This is the first report of the use of EAP to treat anxiety. The mechanism of action of EAP may be via modulation of neurotransmitters. Key words: Anxiety; EAP; case report. Introduction: Anxiety disorders are common and cause considerable morbidity. Contemporary treatment approaches involves psychological and biological methods. Pharmacological treatments mainly involve the use of benzodiazepines, azaspirones and antidepressants. The use of these drugs is not without problems: unpleasant adverse reactions and more importantly dependence and abuse. Moreover some pharmacological interventions may be expensive. Comp Med is becoming more popular with the public and professionals. A 1990 survey(1) revealed that Americans made an estimated 425 million visits to providers of unconventional treatments. Among all the Med conditions studied in the survey, anxiety disorders were the second most common. AP was one of 18 therapies listed in the survey. Med AP involves inserting needles either into AP points or tender points in the skin. These points can be further stimulated by manipulation of the needle, applying heat to the needles (moxibustion) or by applying current to a pair of needles (EAP). The indexed literature has no previous reports of the use of EAP to treat anxiety. We report a case of generalised anxiety disorder which was successfully treated by EAP. Case report: A 33-yr-old woman was referred to the outpatient clinic with a history of worsening anxiety. These episodes of anxiety would come on gradually and last for several h. The patient had these episodes intermittently over the last 9 yr. She had used lorazepam with success in the past to alleviate her anxiety. However she did not wish to take medication on this occasion. There was no family history of psychiatric illness. Her childhood was an unhappy one due to parental marital disharmony. She left school aged 16 with mean qualifications. She had worked with a major company as an engineer since the age of 18. Her first marriage lasted 7 yr. Her most recent relationship lasted 2 yr and ended 2 mo before being seen. She has 2 young children from her first marriage. She lives in her own home and has financial debts incurred by her last boyfriend. She has never abused any illicit substances. Mental state examination revealed a tall, blond, young, white female who was casually and appropriately dressed. She had appropriate eye contact but sat uncomfortably and was restless during the interview. Her mood was anxious. There was no evidence of a depressive illness. Her speech was coherent and spontaneous. There were no obsessional phenomena present. Her cognitive functions were intact and insight was present. A diagnosis of generalised anxiety disorder was made. Treatment options were discussed with her and a course of EAP offered and accepted by the patient. Method: Sterile disposable AP needles (0.5" length and 0.22mm diameter) were inserted at the following AP points: Bilaterally at LV03, SP06, ST36, LI04 and TH16. A needle was also inserted at CV13. The names of the points refer to supposed Channels and the numbers refer to the location on the Channel. These AP points are regarded as "nervous tension points" and used as standard treatment. EAP (square wave, frequency of 50 Hertz) was applied bilaterally to the needles at LI04. The intensity of the current was slowly increased until the patient felt either a tingling or warm sensation at the needle site. Treatment duration was for 30 min once/wk for 6 wk. The treatment was carried out with the patient reclining in a comfortable chair. Conversation with the acupuncturist (HR) was minimal during the treatment sessions as is standard practice for this form of treatment. The 30 item General Health Questionnaire(2) and the Zung Self Rating Anxiety Scale(3) were used at baseline, 8 wk, 3 mo and 6 mo. Results: The General Health Questionnaire and Zung Self Rating Anxiety Scale scores both reduced substantially after the treatment intervention (Table 1). Table 1 Scores of General Health Questionnaire (GHQ30) and Zung Self Rating Anxiety Scale (SAS).
GHQ        SAS

Baseline 25 55
8 Wk 8 31
3 Mo 14 26
6 Mo 0 21

The patient was followed up at 3 and 6 mo from the original referral and continued to improve without any further EAP. There was initial improvement in the severity and frequency of her anxiety attacks. After the third AP treatment there was transient deterioration in her symptoms. There were no external factors to account for her deterioration. After the 4th AP treatment she was much improved and at the end of the course of treatment she was almost symptom free. She remained well at 3 mo and was discharged from the clinic. Discussion: Anxiety disorders do of course wax and wane and a spontaneous resolution may be a possible explanation for the improvement in the above patient's mental state. The novel treatment, which includes needles being inserted and being wired up to an electronic machine may of course constitute a powerful way of eliciting the placebo response. Finally the act of simply sitting quietly for 30 min once/wk for 6 wk may have been akin to a form of meditation and may be a contributing factor. Although non-specific factors contributed to the treatment, EAP as described above had a specific therapeutic benefit. The patient reported no adverse reactions to treatment. EAP should not be used in patients with a pacemaker; malfunction of the pacemaker is a theoretical risk(4). Research on animals and humans has shown that EAP modulates neurotransmitters(5). The type and proportion of substances modulated depends on the frequency of the current. Low frequency (4 Hz) releases endorphins and enkephalins. High frequency modulates 5-HT, dopamine and noradrenaline. EAP should be further researched. Its role in psychiatry looks promising if indeed it modulates 5-HT.

Acknowledgement: We thank Dr A Sanderson, Consultant Psychiatrist, South Bedfordshire Community Health Care Trust, UK, for permission to publish.

1. Eisenberg DM; Kessler RC; Foster C; Norlock FE; Calkins DR; DelBanco TL (1993) Unconventional Med in the USA: Prevalence, costs and patterns of use. NEJM 328:246-252.
2. Goldberg DP (1972) The detection of psychiatric illness by questionnaire. Oxford Univ Press.
3. Zung WWK (1971) A rating instrument for anxiety disorders. Psychosomatics 12:371-379.
4. Rampes H; James RC (1995) Complications of AP. AP in Med 13:26-33.
5. Han JS (1986) EAP: an alternative to antidepressants for treating affective diseases?. Int J Neurosci 29:79-92.

Romoli_M1; Giommi A (1993) Ear AP in psychosomatic Med: the importance of the Sanjiao (triple Heater) area. AETRIJ Jul-Dec 18(3-4):185-194. SIRAA (Societa Italiana di Riflessoterapia, AP, Auricoloterapia), Prato, Italy. 50 patients with possible psychosomatic disorders of the cardiovascular, respiratory and digestive systems were treated with Ear-AP. Together with a control group of 20 symptomless volunteers, they were treated once/wk for 4 wk and a final check of the therapy was made after 6 wk. All subjects were examined with the MMPI test, Paykel's scale for stressful life events, and with the SRT scale (Symptom Rating Test) for measuring at each treatment the variations of anxiety, depression and somatisation levels. Both groups responded similarly to AP but the response was significantly better in the stress group for the reduction of the SRT score and the number of Ear-AP points. The outer ear was sensitized by stress response in certain recurrent areas, especially of the cavum conchae. The TH (Sanjiao) area had the highest relative density of Ear-AP points.

Romoli_M2; Giommi A (1994) Ear AP and psychosomatic medicine: right-left asymmetry of AP points and lateral preferences: Part 2. AETRIJ Jan-Mar 19(1)11-17. SIRAA (Societo Italiana di Riflessoterapia, Agopunctura, Auricoloterapia), Prato, Italy. A group of 50 patients with possible psychosomatic disorders was examined with 5 right-left preference tests: Oldfield's Handedness Inventory, and Coren and Porac's preference tests for hand, foot, eye and ear. The patients were sorted into "complete right" (consistent answers) and "incomplete right" (having answered "left" to at least one question) groups for each of these different tests. The sensitization of the left ear, particularly of the TH (Sanjiao) area, is higher in the complete right than in the incomplete right group. The side to treat with AP is important for diagnosis and therapy.

Tian_L; Yuan S; Ba E; Chen H; Zhou Z (1995) Composite AP treatment of mental retardation in children. JTCM Mar 15(1):34-37. Inst of AP, China Acad of TCM, Beijing, PRC. 128 children of mental retardation were diagnosed in accordance with the 1985 diagnostic standards proposed by WHO. The patients were treated compositely with AP, Ear-AP by pellet pressure, and herbal plasters on AP points. The effects were assessed by recognized intelligence tests for children. AP treatment improved mental development (as assessed by IQ) and social adaptation behaviour (SAB).

Wanning_T (1993) Healing and the mind/body arts: massage, AP, yoga, Taiqi, and Feldenkrais. AAOHN J Jul 41(7):349-351. The health practitioner may encounter clients who are faced with problems that do not seem to respond to traditional health care. One way that some choose to confront these systemic complaints is to employ some of the health traditions of other cultures and to view the body and mind as a balanced whole. 3. Massage, AP and acupressure, Taiqi, and Feldenkrais focus on the mind/body connection to facilitate healing through relaxation, pressure points, and movement.