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Page 2 - Acupuncture and Emotion
Fear And Panic: A Case Study
"Extreme fear," says the "Huang Ti Nei Ching", "is injurious to the kidneys." An example of long felt fear and its taxing effects on kidneys was presented to me in a phone call last year. "Can you help me?" came a man's faint voice. "I'm agoraphobic; do you know what that means? Have you ever treated this condition?" I told him I hadn't treated it but knew that it was a debilitating anxiety disorder marked by fear of public places and situations that are associated with panic attacks. "That's it," he said. "I haven't been away from my house in six years. Only, I get attacks even when I'm at home. Sometimes my heart starts beating like crazy, like I'm going to have a heart attack or go nuts."
The man's symptoms conformed to the DSM (Diagnostic and Statistical Manual) requirements for panic disorder. These requirements are four episodes in a four-week period, featuring four of these symptoms: pounding heart, tightness in the chest, shortness of breath, feeling of choking, tingling, faintness, shakiness, trembling, fear of losing control, hot flashes, a sense of unreality and a fear of going insane or dying. To compound these troubles, comments Jerilyn Ross in her book, Triumph Over Fear, while "the fear during an attack is real, raw, crushing, and overwhelming...physicians tend to write off patients as neurotic or hypochondriacal"(5). This may be a monumental oversight if one considers that 2.4 million Americans suffer from panic disorder in any given year (National Institute of Mental Health).
The man on the phone drew a deep breath. "It means you'd have to come to my house," he said, "since I can't go out." I drove to the upscale section of Los Angeles where he lived. His house, a sprawling mass of glass walls and sharply angled stucco slabs, was a specimen of the atomic era. And like the atomic era, it was a vision gone bad. Currently, the expansive yard was overrun with weeds and the many windows were covered by torn, yellowed curtains and sagging, rusty blinds. Kicking aside an empty mayonnaise jar, I walked a wide limestone path to his door.
The man who answered my knock was six feet tall, fifty years old and was clearly a frail version of his former self. Noticeable also were deep brown circles under his eyes (kidney area of the face). While he retained a full head of hair, it was unmanageably dry and had been corralled into a ponytail. "Come in," he said, waving me into a musty hall. He handed me his dry, bony hand to shake. His name was Frank and for many years he had been a successful stunt driver for television. The "King of Car Chases", they had called him.
Unfortunately, he had experienced three mishaps in the course of six months, the last of which landed him in a full body cast. Upon recovery from his most recent accident, he found himself unable to drive to work; panic gripped him when he got behind the wheel. He had tried therapy without success (probably a poor choice of therapist), had spent a fortune on therapeutic audiotapes and books and, because of his refusal to take medication, was considered "a faker" by his family.
Based on query and observation, I formed a diagnosis and treatment plan. While many agoraphobics cannot locate the specific cause of their disease (it may be the accumulation/magnification of perceived dangers), Frank's crippling fear seemed traceable to his continued mishaps and their potential future recurrence. "Kidney Qi energies," writes Leon Hammer, M.D., in Dragon Rises, Red Bird Flies, "help us to anchor ourselves in the gestalt of the 'here and now'..."(6). Overall depletion of the kidneys was manifested in a deep, weak kidney pulse (the proximal position on the radial artery), lower back pains, tinnitis, palpitations, dizziness and dark pouches under his eyes. Chronic fear had taxed Frank's kidney Yin, as his dry hair, skin and acquired boniness attested. He was the shriveled relic of a once-daring stunt driver. His depleted kidneys failed, as the Nei Jing says, "to do energetic work and excel through...ability." Frank's abilities were being wasted, although I wasn't certain the world would be improved by more car chases. Nevertheless, I decided on a therapeutic principle and a "points strategy" as outlined in The Treatment of Disease in TCM.(7) I determined to supplement the kidneys, fill the essence, and fortify the will. My formula would have been a modified "Liu Wei Di Huang Wan", except that Frank was in terror of herbally-induced panic. Herbs were not an option. Predictably, Frank was also in fear of needles. I therefore gave him a kidney-enhancing mix of shiatsu and tuina, later convincing him to accept but four needles (L14 and LIV3 bilaterally) to "open the gates" and allow Qi to flow.
When I returned to the office, the phone was ringing. Frank was in a panic. The unleashing of the Qi prompted by my nominal needling had caused him alarm, triggering a panic attack. I reassured him and talked him into a calm state of mind, agreeing to return the following day. In subsequent twice-weekly visits, I gave him nothing but acupressure and tuina, always with the purpose of stoking kidney fire. Over the course of several months, he reported gradual improvement and began venturing away from home, driving to the mall with family and attending church. While there are occasional setbacks, his overall outlook is favorable. An increasingly confident and robust Frank is now searching for a qualified therapist... and, at my urging, a desk job.
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