Acupuncture And The Chakras

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http://medicalacupuncture.com/aama_marf/journal/vol17_3/article_5.html Acupuncture And The Chakras Michael Greenwood, MB (MD) ABSTRACT The concept of chakras is not generally considered part of the acupuncture paradigm. Yet like the acupuncture points of Chinese medicine, the chakras are energy nodes with specific functions and correlations. The author suggests that a familiarity with the chakras can be a useful adjunct to medical acupuncture, and interested practitioners can find simple ways of integrating concepts of chakras with traditional acupuncture theory. KEY WORDS Acupuncture, Chakras, Kundalini, Energy Field, Chong Mai INTRODUCTION Most acupuncture practitioners are familiar with the term chakras, the energy centers of Vedic philosophy and Ayurvedic medicine. But, since they arise from another tradition, there is little mention of chakras in acupuncture texts nor conversely, much talk about acupuncture in books on chakras. However, a cross-referencing of acupuncture theory and chakra-based theory can be clinically useful. For example, consider how closely this description of shakti, prana, and nadis resemble the Shen, Qi, and acupoints of Chinese medicine: ...She (Shakti) becomes the five elements and combines them to make different forms...She makes the body – consisting of seven constituents and 72,000 nadis - and enters it as prana. She is present everywhere in the body in subtle form. There She causes prana to move through the nadis at lightning speed. She circulates blood in a systematic manner...1 What Are The Chakras? Modern physics has revealed that beyond the superficial appearance of structure, the universe is an infinite vibrating energy field, which is organized according to harmoniously resonating intervals.2 Similarly, beyond its superficial material structure, the human body has an energy field that has maximal intensity in and around the physical body, but which extends outward into space toward infinity, albeit with diminishing intensity the further out one goes.3 The various energies flowing in and around the body vibrate at their own frequencies and resonate harmoniously at nodes, known in Ayurvedic medicine as chakras and marmas. Although different sources describe varying numbers and locations of these nodes, there is a general consistency about the 7 major nodes that run down the center of the body (Figure 1), while the more numerous marmas might well correlate with the acupuncture points of Chinese medicine. Meantime, the prana, like the Qi of Chinese medicine, runs in channels or nadis, perhaps similar to the acupuncture meridians. Chakra Location and Classification The names of 7 chakras are listed in Table 1. Note that the Ayurvedic and Chinese elements are not the same. This is indicative of the fact that the symbolic meaning of the elements in each tradition does not necessarily correspond. The acupoints too are not direct correspondences, but only best-guess approximations based on similarities of chakra and point locations. The Personal (Ego) and the Transpersonal Chakras can be categorized as a trinity of lower, middle, and upper, which refer to the physiological (ego), soul (Heart), and spiritual (transpersonal) levels. Conceived of this way, an interesting symmetry becomes apparent: in both the upper and the lower grouping, specific chakras reflect the principles of the void (Tao), individuation (agency or Yang), and connection (communion or Yin). The lower 3 chakras reflect these themes as they relate to the personal or individual ego while the upper 3 chakras reflect the same themes as they relate to the transpersonal (Figure 2). Meantime, the Heart, as the sovereign of the body-mind-spirit and container of the Shen, functions to integrate the personal and the transpersonal into a unified whole. Many people live from the first 3 (lower) chakras, never accessing the transcendent resources of the Heart and upper centers. Yet the possibility of opening to them is always present and may be actualized through a creative encounter with illness in which the ego becomes aware of and learns to channel the transpersonal energies immanent in the illness symptoms. The beginning of such a transformational process has been described in Chinese medicine as passage through the Golden Gate.4 The reception and channelling of transpersonal energies is generally accompanied by an attitudinal shift in which the ego's customary stance of alienation gives way to a sense of universal interconnectedness. Koven states: At higher levels of the I-continuum, Consciousness is both self-aware and aware of its interrelationship with every part of the Universe. All existence is holographic, each part containing the imprint of the whole and each affecting the Universe in intimate and extraordinary ways.5 Despite its philosophically holistic underpinnings, acupuncture as it is customarily practiced uses dualistic diagnosis/treatment protocols and therefore, remains largely an ego-level intervention. At this level, energy may be tonified, sedated, or otherwise moved around, but the underlying gestalt, which gives rise to the illness state (which lies in the ego's sense of separateness), often remains unchallenged. Furthermore, even if temporary symptom relief is achieved through such a process, without a concomitant integration of the emerging transpersonal energies, the acupuncture ritual risks becoming addictive. The result may be little more than a change of dependency from one therapy (perhaps drugs) to another (acupuncture). Taking acupuncture beyond the ego-level requires the development of non-dualistic models. Sankey, for example, has explored esoteric acupuncture using models spanning the Qabbala, chakras, and sacred geometry.6 Every model has its merits, but the chakra system is so simple and well-known that it almost begs to be included in an acupuncturist's toolkit. Furthermore, the model makes it visually clear that there are energy centers beyond the ego level and implies that an aspirant looking for healing needs to explore these upper centers as part of the journey to health. However, doesn't the Five-Element model address this issue? Perhaps not. The Five-Element system describes personality characteristics that, by definition, are energetic tints through which an alienated ego views the world. In contrast, a fully integrated individual sees the world as it is, without the trace of a tint. Consequently, although the Five-Element model may be capable of facilitating the healing journey up to the edge of the ego boundary (symbolized by the Golden Gate), successful traversal through the gate involves sacrificing the tint. Consequently, what happens thereafter must, by definition, transcend the Five Elements. The chakra system can give us a glimpse into that world beyond the ego boundary, beyond the Golden Gate. The upper and lower chakras, depicted as triangles with their apices directed toward a central Heart integrator, are shown in Figure 2. Note that the symbol for the Heart chakra (Figure 3) is a condensed form of this same image. The symbol implies that wholeness reflects an integration of the personal and transpersonal, the individual and the transcendent, through the mediating faculties of the Heart. In addition, although the symbol comes from Asian traditions, in Chinese medicine, the image of overlapped triangles can be traced back to the Book of Changes (700 BC), while the image of three upon three forms the basis of the hexagrams of the I Ching. Then again, in Western tradiions, it shows up in the Star of David. It is very much a transcultural image. If the triangle with apex pointing downward is taken as the symbol for the Water element, while the triangle with the apex pointing upward is taken as the symbol for the Fire element, then the image of overlapping triangles exactly mirrors the Chinese medicine concept of the Heart-Kidney, Fire-Water axis. I. The Root Chakra – Mulahadara The first chakra is said to be located at the base of the spine just below the coccyx, behind the anus, and is described as a red lotus with 4 petals. Chinese medicine describes 2 points in the area: GV 1 (changqiang), located behind the anus at the base of the spine, and CV 1 (huiyin), located in front of the anus. CV 1 is regarded as the most Yin place on the body and therefore a source of primal Yin energy. Similarly, Ayurvedic medicine conceives the root area to be the source of a primal energy known as Kundalini. In the Vedic tradition, the root chakra is associated with groundedness, connection to the Earth, and the instinct for survival.7 Because of this elemental association, it is tempting to associate the root chakra with the Earth element of Chinese medicine. But, perhaps the Water element makes as much sense. Undeniably, the sense of grounding/centering of the root chakra may well relate to Earth, but the notion of a deep potential out of which things arise and manifest is more in tune with the Water element. Those who cannot mobilize their root energy often spiral downward into a life of invalidism, as all their avail-able energy lies stagnant in the 1st chakra. Such people, expressed symbolically by the out-of-balance Shao-Yin Water biopsychotype, can find life a constant struggle and sometimes live in a chronic state of being overwhelmed, never able to get moving in life.8 Both Water and root are concerned with deep personal resources and unmanifest potential. When illness arises in those so predisposed, the area around the root chakra is a frequent locus for stagnation to occur. For example, common problems might include low back and sacral pain, hemorrhoids, constipation, or prostate difficulties. Related symptoms may overlap into the 2nd chakra, manifesting as lumbar discomfort or sexual hyper/ hypofunction. When someone consistently produces problems in this area, it is suggested that they are a Water CT. CASE REPORT 1 Root Chakra The patient was a 35-year-old man of a Tai-Yang Water constitution who injured himself falling off a ladder, straddling a 2-x-4 in the fall. He developed chronic perineal and erectile pain, and situational depression. Treatment included (among other things) a Tai-Yang - Shao-Yin N+1 circuit, utilizing BL 62 (Shenmo) and KI 6 (Zhaohai) to incorporate the CV and GV, plus needles in CV 1 and GV 1 when he seemed ready to accept them. During a session, the patient entered the void and started to shake uncontrollably, his pelvis moving in ways he would not normally have permitted. After that particular session, his erectile pain dissipated. II. The Sexual Chakra - Svadhisthana Sometimes called the navel center or Hara, the 2nd chakra is located between the pubic bone and the navel. It is described as an orange lotus with 6 petals and is traditionally associated with nutrition and sexuality.9 Like the root chakra, this node shares some common ground with the Chinese medicine conceptions of both the Earth and Water elements. However, perhaps the Earth element is the better match as sexuality, creativity, and nutrition are so central to all levels of the body-mind-spirit. Furthermore, svadhisthana is also clearly concerned with interpersonal connection, which is very much an Earth theme. The Ming Men and Kundalini Chinese medicine calls the area below the umbilicus the dantian and considers it to be a storehouse of energy. Points with names such as CV 6 (Qihai) and GV 4 (Mingmen) are superficial reflections of the actual mingmen, which is an internal energy generator located midway between the 2 kidneys. In Chinese medicine theory, energy generated from the mingmen passes down to CV 1 to supply the extraordinary meridians before being distributed to the rest of the body via the Triple Heater. In the Ayurvedic tradition, Kundalini energy is the basic energy or creative force and is said to lie dormant at the base of the spine until mobilized through special meditation and breathing techniques.10 The classic image is of 2 sleeping serpents, coiled around the base of the spine, near the coccyx. When the serpents are awakened, energy begins to flow up the spinal column through 3 energy channels, or nadis, to open the higher chakras in succession. The first of these channels, Sushumna, is the central column and perhaps corresponds to the Chong Mai. The other 2, Ida and Pingala, are depicted by the 2-coiled serpents around the Sushumna, and may represent the Du Mai and the Ren Mai. Although the correspondences are not exact, Ida is said to carry cool lunar, Yin energy, and might be said to correspond to the Ren Mai. Conversely, Pingala is said to carry warm, solar, Yang energy and could be said to correspond to the Du Mai. It should be noted that Sankey and others equate the Sushumna directly with the Du Mai. Though this solution may be technically more accurate, it becomes constrained to associate Ida and Pingala with somewhat obscure para- Du Mai connecting channels in which Qi flows in an ascending direction.6 Perhaps it is feasible to hold both concepts in mind simultaneously since the theoretical validity of an interpretation is less important than its practical applications. Specifically, the opening and coupled points of either the Chong Mai (SP 4 [Gongsun], HP 6 [Neiguan]), or the Du Mai SI 3 [Houxi], BL 62 [Shenmo]) may be used on occasion to help access the Kundalini. The Chong-Mai Split Since the chronically ill are often exhausted, it would probably benefit them to access this freely available energy source, which lies hidden beyond the sight of the ego. However, one thing that can bar access to the mingmen energy is a deep-rooted block that arises from a collective fear and shame of sexuality, a block that psychologists have called a love/sex split, but which might also be understood as a Chong-Mai split or block.11 The block arises when the sexual energies are split off from the rest of the body-mind during the period of ego construction. A Chong-Mai block generally manifests as 1 of 2 distinct containment/dissociation syndromes that, although easily identifiable, often go unrecognized in clinical practice.12 In the first, when containment is the dominant response, there is tension and Qi congestion in the pelvic area with deficiency above; in the second, there is Qi congestion in the upper chest and head, with energy deficiency in the pelvis. In the latter case, there is often a palpable temperature differential between upper and lower Jiaos, with hot above and cold below. CASE REPORT 2 Sexual Chakra A 45-year-old woman presented with migraine headaches that she managed in the usual way with prodromal tryptans and the occasional meperidine rescue. She suspected that there might be a deeper meaning to her headaches after attending a woman's workshop in which issues of childhood abuse were discussed. Examination revealed a hot-above/ cold-below scenario with the temperature differential occurring somewhere in mid-abdomen. After some preparation and counseling, the patient expressed a wish to reclaim her disowned pelvic energy through an experiential exploration. Acupuncture was initiated with opening and coupled points of the Chong/Ren/Du Mai and local points in the lower abdomen and low back such as CV 4-6, ST 28-30, GV 4, and BL 23-26, and she was encouraged to physically move the pelvis. In time, as she learned to pull the diverted excess upper Jiao energy down to the pelvis, her headaches diminished and eventually disappeared. III. The Solar-Plexus (Power) Chakra - Manipura Although some sources connect manipura with the mingmen and locate it at the level of the navel, others describe it as being the solar plexus or power chakra, located between the navel and the xiphisternum at CV 12 (Zhongwan), the Mu point of the Stomach, or on the back at GV 6 (Jizhong) and GV 8 (Jinsuo). It is described as a yellow or gold lotus with 10 petals and is traditionally concerned with power, control, recognition, and status.13 The chakra is activated when there is a need to set boundaries or otherwise make a statement of personal power. Self, Anger, Expression, Power The desire to connect and harmonize with others, arising from the 2nd chakra energies, can produce challenging situations when external demands become unreasonable, excessive, or manipulative. The conflicted feelings will often engender a sense of pulling or tugging in the solar-plexus area, as if the area were tethered to a cord. In esoteric literature, these energetic tetherings have been called Aka cords.14 From a Five-Element perspective, such situations generally call for either: (1) boundary setting (Wood), mediated by the solar-plexus chakra, or (2) "letting go and moving on" (Metal), which is perhaps more the purview of the throat chakra. Either (or both) of these may be unavailable to those who have not brought such energies to consciousness. Instead, many people give the perception of equanimity by containing their resentment, which may lead to the syndrome of "Wood invading Earth" and manifest as gastritis, reflux, food sensitivities, or peptic ulcer. In another scenario, Wood energies can get pushed down into the lower Jiao where they intermingle with and contaminate the contained/dissociated sexual energies, leading to a situation in which sexual and Wood energies are mixed and compartmentalized outside of rational consciousness. The story of Dr. Jekyll and Mr. Hyde illustrates this dynamic.15 IV. The Heart Chakra - Anahata The Heart chakra, or anahata, is anatomically and energetically the center of the body-mind.16 Located in the middle of the chest at CV 17 (Danzhong) and on the back at GV 11 (Shendao), it is traditionally described as a green, orange, crimson, or gold lotus with 12 petals. The essential feature of the Heart energy is its capacity to acknowledge and be present with what is.17 Chinese medicine conceives Heart (Heart Yang) and Mind (Heart Yin) to be a Yin/Yang pair, and fuses them together as Heart-Mind or Xin.18 By separating Heart and Mind and relying solely on the intellect, many people have inadvertently forgotten the importance of the Heart center, which manifests as presence and compassion rather than planning and strategy. An open Heart permits both physician and patient to release the habitual compulsion to fix or change things. This has its therapeutic advantages. For example, when patients become present, they may stop an often self-destructive quest to eradicate symptoms and instead become curious about them. Moreover, physicians soon discover that the phenomenon of presence forms the basis of the art of medicine. Though it may be interpreted superficially as inaction, compassionate presence can occasionally facilitate dramatic energy shifts that cannot be explained with the standard cause and effect model. How is it possible, one might ask, for symptoms to disappear when nothing is done? The idea is not reasonable. Yet such experiences happen and when they do, they can quickly transform the patient's attitude and simultaneously, reframe a physician's view of health, illness, and medicine. The world is the same world but somehow, everything looks different. In Vedic philosophy, the root, heart, and forehead chakras are said to contain knots or granthis, representing aspects Brahma (the creator), Vishnu (the preserver), and Shiva (the destroyer), respectively. It is these knots that are pierced by rising Kundalini energy as the aspirant breaks the bonds of ignorance that tether him/her to duality. Located in the root with the sleeping serpents, the knot of Brahma may be loosened when the Kundalini first becomes activated; while the knot of Vishnu, located in a trikona or inverted triangle in the Heart lotus, may be released through a transformational experience in which the ego is temporarily transcended. In this respect, the knot of Vishnu parallels Chinese medicine's Golden Gate.19 CASE REPORT 3 Heart Chakra A 43-year-old woman of Shao-Yin Fire presented with headaches and total body pain. She had been in 2 motor vehicle collisions. Associated symptoms included depression, insomnia, and asthma. There was a history of physical and emotional abuse in childhood, and she was taking numerous medications including oxycet, gabapentin, various antidepressants, and anxiolytics. Acupuncture treatment included, among other things, attention to the Shao-Yin – Tai-Yang circuit, CV 17 (Danzhong), BL 15 (Shenshu), and GV 11 (Shendao). After several sessions in which nothing appeared to shift the pain, the patient attempted being totally present, reversing her customary habit of pain avoidance through continual movement and abreaction. Shortly after initiating this strategy, in the context of a triangular equilibration of the Shao-Yin, the patient entered a calm state and assumed a position resembling crucifixion. After 10-15 minutes, she emerged pain-free and laughing. She later described the experience as finding a center in the middle of chaos. V. The Throat Chakra - Vishuddsha Located just above the notch at the top of the sternum, the throat chakra is said to be a lotus of 16 petals, mauve, silver, or greenish-blue in color, and oval. It is the energy center related to expression and communication, inspiration, and detachment, which is why perhaps it has been associated with the Metal element in Chinese medicine.20 Letting go at the ego level may temporarily dissipate pent-up energy in the power center but eventually, a similar situation will arise, re-creating the habitual tension. On the other hand, letting go with an open Heart in a conscious and open expression of one's personal truth through a clear throat chakra not only prevents a build-up of tension but also, confirms agency and transcends the ego. There is a difference between venting angst and consciously speaking one's truth. The power to express is a double-edged sword that needs to be wielded with great care. If the Heart is open and Heart and Mind are one, then the energetic expression will generally be positive and life-supporting. On the other hand, if the Heart and Mind are separated, then the energetic expression may lack compassion. For physicians, this can be a critical issue, because scientific medicine and evidence-based protocols can be remarkably depressing if delivered with cool indifference. The art of medicine will always remain rooted in the dual skills of presence and compassionate communication. CASE REPORT 4 Throat Chakra A 35-year-old man of Jue-Yin Wood developed a stutter following a motor vehicle collision 2 years previously in which he had sustained mild whiplash. During 1 treatment session in which needles were placed in points such as KI 25 (Shencang), KI 27 (Shufu), CV 22 (Tiantu), and ST 9 (Renying), he felt a surge of heat up to his face. Immediately after the session, his stuttering disappeared as did his nearsightedness for which he had worn glasses for a number of years. VI. The Forehead Chakra - Ajna The 6th chakra has been called the third eye, and is located between and just a little higher than the eyebrows in the center of the forehead. It has been described as a lotus divided in 2. One half is chiefly rose-colored with yellow tinges, and the other half is primarily purplish-blue, each half having 48 petals.21 The 6th chakra is related to intuition, that inner vision that sees the truth directly, and has been associated with a whole brain function in which the frequency of brain waves range below the normal waking state (these frequencies are alpha [7-14 Hz], theta [4-7 Hz], and delta [0.5-4 Hz]; in contrast, normal waking consciousness generally produces frequencies in the beta range [14-35 Hz]). Such inner vision is functionally distinct from regular vision. Because the physical sense of sight is outer-directed, it is constrained to the duality of observer and observed. Intuition, on the other hand, is an inner-directed, unmediated knowing, in which knower and known are somehow connected or even united. In Chinese medicine, GV 24.5 (Yintang) is sometimes referred to as unnamed because the process of naming creates the very duality that the third eye transcends.22 Total brain coherence is a style of functioning that both transcends and includes the 3 states of waking, dreaming, and sleeping, and is known as turiya in the Ayurvedic tradition. As intuition develops, the individual becomes increasingly able to directly sense the root of things and situations without having to analyze or filter information through the reasoning faculties. The more intuition is trusted, the better it functions; and the better it functions, the more trust it deserves. Optimal functioning of the throat and Heart centers is crucial to such seeing, which is compassionate and nonjudgmental. To see truth completely is to see it lovingly, because there is no separation between observer and observed. Judgment separates observer and observed, creates the sense of duality, and leads to blockage or stagnation of Liver Qi. It is perhaps unfortunate that Western medicine diminishes the value of intuition in favor of left-brained rational thought, because the loss of intuition can be an impediment to a full understanding of the disease state. Without it, there is a tendency to restrict the search for cause to external factors such as bacteria or carcinogens, and to miss the opportunity offered by an illness to rediscover meaning and insight. CASE REPORT 5 Third Eye A 55-year-old First Nations man of a Tai-Yin Metal constitution presented with low back and knee pain. He did not talk much but when he did, he usually had something profound to say. During several sessions of acupuncture, in the context of a Tai-Yin/Yang-Ming circuit, GV 24.5 and local points around the knees, he retreated into the far reaches of the void, returning to describe visions and insights that seemed to go beyond his personal memory. In one, he journeyed into a hellish world where he saw the devastation of his people through smallpox. In another, he soared with ravens and eagles. In another, he saw his people being killed in a big battle which he felt was the battle of Wounded Knee. After this vision, during which he was deeply impressed by the synchronicity between image and symptoms, his knee pain disappeared. VII. The Crown Chakra – Sahasrara (Atma) The 7th, or crown, chakra is the gate to the ultimate state of consciousness, union with the divine. Called sahasrara by yogis, it is sometimes known as the lotus of a thousand petals and is predominantly violet, white, or gold.23 Chinese medicine refers to this point as Baihui (GV 20, hundred meetings), perhaps an echo of the yogic thousand petals. Located at or slightly above the vertex, the crown chakra connects the individual to absolute reality – the Tao, or ultimate void, which both permeates and transcends duality. Though impossible to mentally understand, the Tao can perhaps be intuited by entering a kind of expanded awareness where knowing is experienced as being. In that vein, there is no doubt that miraculous things can happen in the treatment room when the physician is not actually doing anything in particular. Experience paradoxically teaches that the most effective practice is often nothing procedural. Being rather than doing, offering presence and refraining from interfering with whatever is happening, can be remarkably therapeutic. To quote the Tao Te Ching: Few things under heaven are as instructive as the lessons of Silence, Or as beneficial as the fruits of Non-Ado.24 In addition, a few verses further on say: Learning consists of daily accumulating; The practice of Tao consists in daily diminishing. Keep diminishing and diminishing Until you reach the state of Non-Ado, Non-Ado, and yet nothing is left undone.24 It can be a great shock to discover the power of non-doing, but its utilization as a therapeutic maneuver is not without some justification. Since no one can ever understand all the factors involved in another's illness, not acting is at least as sensible as acting and quite often leads to genuinely favorable outcomes. Furthermore, the principle of non-action is at the core of the Chinese medicine philosophy and informs the state of wu-wei, or effortless mastery. In this state, the practitioner simply intends, without any particular effort, and sets a context for spirit to express itself through the acupuncture ritual. I have witnessed several crown chakra openings in which patients experienced an enormous flow of energy through the body, originating from the GV 20 area and pouring down through the body, followed by marked symptom amelioration. Some of these people had a prior diagnosis of a seizure disorder and had been taking antiepileptic medications, but chose to reduce the dose in preparation for a void exploration. In these cases, the patients' own convictions that they had a pathology was the single most important factor preventing them from accessing the healing experience. Unfortunately, such pathologizing of the flow of transpersonal energies by Western medicine is very common.25 CASE REPORT 6 Crown Chakra A 46-year-old woman with systemic lupus erythematosus (SLE) had been dependent on a wheelchair for years because of flexion contractures of her elbows, hips, and knees. One day, she entered the office springing up and down on her perfectly normal legs. She said she had attended a prayer meeting with thousands of people, during which she felt a bolt of energy enter through the top of her head. Immediately, she was able to get out of her chair and walk. CONCLUSIONS Though detailed instructions on acupuncture/chakra balancing are beyond the scope of this article, they can be found elsewhere.6 Nevertheless, even without an in-depth study of the subject, the general concept of chakras can easily be kept in mind during an acupuncture session, and appropriate points needled when symptoms suggest a particular chakra is involved; or, if someone is in a suitable psychospiritual state reflecting the function of a particular node. Chakra points can be integrated into specific meridian circuits, used as focusing points in a resonating triangle balance, utilized to facilitate Qi movement in the CV-GV circuit, incorporated into Zang-Fu tonification protocols, or used simply as Ah Shi or trigger points. For example, someone looking for inspiration might benefit from a needle in GV 20; someone lacking insight may benefit from the use of Yintang; someone struggling with chaos might find some centering with a needle at CV 17, or someone with boundary issues may benefit from needles at CV 12 and GV 8. The astute physician can allow intuition to be the guide as to when and where to add a chakra point to an overall circuit design and can probably find numerous ways to include the system in his/her practice. Beyond that, there may be a deeper necessity to explore the chakras. Specifically, those who by luck or design have traversed the Golden Gate during acupuncture may have experienced the noumenon, in which they found themselves immersed in an energetically interconnected world with their ego temporarily in abeyance.26 Though initially exhilarating, the significance of their experience might easily be forgotten or denied as the ego re-establishes its ascendancy as body-mind sovereign. Following such experiences, though physicians have an opportunity to help stabilize the transformational experience, they may paradoxically find that their "toolbox of protocols" has become strangely inadequate. Since the conventional acupuncture model operates at ego level, continuous use of commonly accepted dualistic approaches may inadvertently serve to retard further progress by keeping patients mired in a small egoic notion of self. To get beyond this difficulty, alternate metaphors such as the chakra model can be very helpful. In my experience, it can be rewarding to work with people who have moved beyond the first 3 chakras. Such people have long relinquished the typical narcissistic strategies that tend to plague initial therapeutic encounters such as naive outcome expectations, manipulative posturing, or a sense of therapeutic entitlement. Moreover, they tend to be genuinely grateful for the acupuncture experience and happy to take full personal responsibility for their use of professional time. In such a therapeutic relationship, the interaction often transforms into a patient-directed journey of exploration, while the practitioner's role becomes that of a witness who holds the space and grounds the experience in the silence of the void. Acknowledgment The graphics were designed by Dr Greenwood's son, Richard Greenwood. REFERENCES 1. Muktananda S. Nothing Exists That Is Not Siva: Commentaries on the Siva S¯utra, VijŠnanabhairava, Gurug¯it¯a, and Other Sacred Texts. South Fallsburg, NY: SYDA Foundation; 1997. 2. Seshadri H, Harihar S. The "Science" of Medicine: Where Modern Medicine Meets Spirituality. Chennai, India; 2002. 3. Greenwood MT. Accumulation/depletion syndrome: the energetic root of stress and burn-out. Medical Acupuncture. 2005;16(3):19-23. 4. Jarrett L. The loss and return of original nature: the Law of Husband/Wife. Am J Acupuncture. 1994;22(1):29-45. 5. Koven JC. Going Deeper: How to Make Sense of Your Life When Your Life Makes No Sense. Cathedral House, CA: Prism House Press; 2004. 6. Sankey M. Esoteric Acupuncture, Gateway to Expanded Healing. Inglewood, CA: Mountain Castle Publishing; 1999. 7. Martin SG. Root Chakra: also known as Security Center, Muladhara. http://www.chionline.com/chakra/Root.htm. Accessibility verified February 17, 2006. 8. Helms JM. Acupuncture Energetics: A Clinical Approach for Physicians. Berkeley, CA: Medical Acupuncture Publishers; 1997. 9. Martin SG. Navel Chakra: also known as sensation center, spleen Chakra, hara, svadhisthana. http://www.chionline.com/chakra/Orange.htm. Accessibility verified February 17, 2006. 10. Gopi K. Kundalini. Shambhala Publications; 1970. 11. Stein R. Incest and Human Love: The Betrayal of the Soul in Psychotherapy. Dallas, TX: Spring Publishers; 1984. 12. Greenwood MT. Psychosomatic compartmentalization: the root of Qi and Blood stagnation. Medical Acupuncture. 2001;13(1):23-28. 13. Martin SG. Solar Plexus Chakra: also known as Power Center, Manipura. http://www.chionline.com/chakra/Solar.htm. Accessibility verified February 17, 2006. 14. Sui CK. Pranic Healing. York Beach, MI: Samuel Weiser Inc; 1990. 15. Stevenson RL. Dr. Jekyll and Mr. Hyde. New York, NY: Penguin Books; 1987. 16. Martin SG. Heart Chakra: also known as Living Love Center, Anahata. http://www.chionline.com/chakra/Heart.htm. Accessibility verified February 17, 2006. 17. Jarrett LS. Chinese medicine and the betrayal of intimacy: the theory and treatment of abuse, incest, rape and divorce with acupuncture and herbs, part 1. Am J Acupuncture. 1995;23:35-51. 18. Greenwood MT. Acupuncture and the Heart-Mind Split. Medical Acupuncture. 2003;14(2):22-27. 19. Greenwood MT. Intention: needling without needles. Medical Acupuncture. 1999;11(1):17-23. 20. Martin SG. Throat Chakra: also known as Cornocupia Center, Vishuddha. http://www.chionline.com/chakra/Throat.htm. Accessibility verified February 17, 2006. 21. Martin SG. Brow Chakra: also known as Consciousness Awareness Center, third eye, Ajna. http://www.chionline.com/chakra/Brow.htm. Accessibility verified February 17, 2006. 22. Jarrett L. Constitutional type & the internal tradition of Chinese medicine, part 2. Am J Acupuncture. 1993;21(2):141-158. 23. Martin SG. Crown Chakra: also known as Cosmic Consciousness Center, "I am" Center, Sahasrara. http://www.chionline.com/chakra/Crown.htm. Accessibility verified February 17, 2006. 24. Tao TC. Shambhala Pocket Classics. Shambala Publishing; 1961. 25. Walsh R, Vaughan F. Paths Beyond Ego: The Transpersonal Vision. Los Angeles, CA: Jeremy P. Tarcher Inc; 1993. 26. Greenwood MT. Needle shock: adverse effect or transformational signal. Medical Acupuncture. 2004;16(1):14-17. AUTHOR INFORMATION Dr Michael Greenwood is Medical Director of the Victoria Pain Clinic, a residential facility in Victoria, British Columbia, Canada. Dr Greenwood specializes in chronic pain/chronic illness patients, developing techniques integrating the body, mind, and spirit. Michael T. Greenwood, MB (MD), BChir, FCFP, CAFCI, FAAMA, FRSA* Victoria Pain Clinic 103-284 Helmcken Rd Victoria, BC, Canada V9B 1T2 Phone: 250-727-6250 • Fax: 250-727-7358 E-mail: michaeltgreenwood@shaw.ca