-IBIS-1.5.0-
tx
cardiovascular system
angina pectoris
psychospiritual approaches

metaphors and correlations

• overconscious of body functions (Jores, p. 299)
• Coronary artery disease is associated with type A behavior pattern. (Gentry, p. 55)
• Denial of symptoms was marked in patients with angina pectoris; in contrast to dramatization of symptoms with angina innocens in which patients have deep-seated anxiety focused on the heart which drives them from doctor to doctor in search of relief of both the anxiety and the pain. (Locke, 1985, p. 102)
• Common psychologic responses to chest pain and diagnosis of coronary artery disease include mild to severe depressive reactions, marked hypochondriasis, and denial that the illness exists. The symbolic meaning of coronary artery disease also varies greatly in patients. The most common problem is the 'hard driver' who has depended on his activity level for his self-esteem. A principle of management is making the patient aware of the neurotic character of some of the activity patterns, and helping him to gratify his drives in alternative ways. Sexual activity is an area of great concern. Drugs are of limited usefulness. (Locke, 1985, p. 120)
• Conscious factors associated with cardiac symptoms include strongly aggressive tendencies which have been totally repressed; appears characteristically in a man who is strongly attached to the father and hostile to the mother; the hostility to the father is repressed and if the father has heart symptoms, the patient may act out the same symptoms as part of his identification with the father. (Alexander, p. 334)
• Cardiac pain is associated with five personality groups: (1) keen sense of duty and rigidity with repression of aggressiveness, (2) defensive of underdog, (3) quitters, (4) overaggressive, (5) "inferior physique" and too attached to mothers.
(Alexander, p. 335)
• Personality differences between angina patients and rheumatic heart disease: angina patients showed compulsiveness, repressed hostility, unfulfilled oral needs, and a strong superego. Rheumatic heart disease patients were passive, nonhostile persons whose oral needs seemed adequately fulfilled. Such factors should be carefully considered in designing a therapeutic program. (Locke, 1985, p. 101)
• In majority of persons (48 of 73) examined in this study, cardiac pain seemed to be manifestation of conversion disorder. (Locke, 1985, p. 101)
• Squeezing all the joy out of the heart; heart represents center of love and security (Hay, 1984, p. 168)
• "Angina pectoris" literally means "tight-chestedness." Fear has manifested itself in a concrete form. Orthodox medicine treats this with a highly original piece of symbolism: patients are given nitroglycerin, i.e. explosives, to blow apart the tightness and create space in the heart once more. (Dethlefsen, p. 201)

Chinese psychophysiology:
Heart ~ Xin houses the Shen (Spirit) and reveals itself through the brightness in the eyes; governs Fire and Heat; rules the Xue (Blood) and its vessels and directs the circulation; and relates to the integration of the organs and the personality.
» Healthy expressions are warmth, vitality, excitement, inner peace, love, and joy.
»
Heart Xu (Deficiency) signs include sadness; absence of laughter; depression; fear; anxiety; shortness of breath (Seem, p. 28); cold feeling in the chest and limbs; palpitations; cold sweat; inability to speak; memory failure; nocturnal emissions; and restless sleep.
» The Heart is the Emperor of the bodily realm so that when the Heart is disturbed all the other organs will be disrupted.

Liver ~ Gan is the residence of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); controls the muscles, especially their contractility; and reflects emotional harmony and movement.
»
Healthy expressions are kindness, spontaneity, and ease of movement.
» Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry skin and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down.
» Liver Qi Stagnation reflects and accentuates emotional constraint as the Liver's function of facilitating smooth flow in the body is constricted. Stagnation is associated with frustration, irritability, tension, and feeling stuck. With time this pattern tends to produce a gloomy emotional state of constant resentment, repressed anger or depression, along with tightness in the chest, frequent sighing, abdominal tension or distension, and/or a feeling of a lump in the throat with difficulty in swallowing. (Maciocia, p. 216)

Kidney ~ Shen stores Jing (Essence) and governs birth, growth, reproduction, development, and aging; houses the Zhi (Will); expresses ambition and focus; provides the stabilizing and nourishing influences of Water to balance the Fiery qualities of the Heart, and displays the effects of chronic degenerative processes, and extreme stress.
» Healthy expressions are gentleness, groundedness, and endurance.
» Kidney Xu (Deficiency) signs include indecisiveness; confused speech; dreams of trees submerged under water; cold feet and legs; abundant sweating (Seem, p. 28); hearing loss; fearfulness; apathy; chronic fatigue; discouragement; scatteredness; lack of will; negativity; impatience; difficult inhalation; low sex drive; lumbago; sciatica; and musculoskeletal irritation and inflammation, especially when worse from touch.
» Intense or prolonged fear depletes the Kidney. Often chronic anxiety may induce Xu (Deficiency) and then Fire within the Kidney. (Maciocia, p. 250) Overwork, parenting, simple aging, and a sedentary or excessively indulgent lifestyle all contribute significantly to Kidney Xu (Deficiency).


therapies

behavior modification:
• attentive breathing techniques (Locke, 1985, p. 102)
• Relaxation techniques combined with biofeedback showed decrease of frequency of anginal attacks, and increased exercise tolerance. (Locke, 1985, p. 103)
• Systematic desensitization has been shown to alleviate angina. (Locke, 1985, p. 100) (Related materia medical listings: anxiety and depression)
• meditation: to effect predisposing behaviors and thought patterns. (Locke, 1985, p. 105) (Related materia medical listings: healing power of meditation)

imagery:
(Related materia medical listings: imagery for heart conditions)
• Visualize blood flow to the coronary arteries. (Rossi, p. 110)

affirmation:
• I bring joy back to the center of my heart. I express love to all. (Hay, 1984, p. 168)
• Joy, joy, joy.
• I lovingly allow joy to flow through my mind and body experience. (Hay, 1984, p. 168)

theotherapy:
(heart disease) Atlas, Poseidon, Prometheus, Typhon (Lemesurier, p. 99)

hypnotherapy:
• Useful in assisting vascular relaxation, and in reframing. (Locke, 1985, p. 101)

psychotherapy:
• It has been suggested that patients with the functional type of cardiac pain and certain patients with angina of effort (with prominence of emotional elements) benefit from psychological treatment. (Locke, 1985, p. 102)
• Cardiac pain is often non-cardiac in origin and many patients have anginal attacks which can be understood only on the basis of a thorough evaluation of the total life situation and the meaning of the anginal reaction as a symbol, a defense, and a compromise solution to a complex problem. (Locke, 1985, p. 102)
• With heart disturbances and heart conditions, the following questions are possibly worth exploring:
» Are my head and heart, my intellect and feelings, in harmonious balance?
» Am I giving enough scope to my feelings and trusting myself to express them?
» Am I living and loving 'heartily', or only 'half-heartedly'?
» Is my life borne along by a living rhythm, or am I subjecting it to a rigid way?
» Does my life still contain enough combustible materials and explosives?
» Am I listening to, seeing, feeling, moving my heart? (Dethlefsen, p. 202)

process paradigm: (experientially oriented)
• What is the symptom preventing me from doing? What is the symptom making me do? (see process interview: cardiovascular system)

related materia medica listings:
the shadow and physical symptoms
converting a symptom to a signal
type A behavior pattern
anxiety and depression
behavior modification techniques
(see also: systematic desensitization, biofeedback relaxation techniques)
imagery for heart conditions
imagery: precautions
imagery: techniques
affirmations: guidelines and precautions
theotherapy
biofeedback
hypnotherapy
reframing
process paradigm


footnotes

Reprinted from The Foundations of Chinese Medicine, Maciocia, Giovanni, 1989, by permission of the publisher Churchill Livingstone, a division of Elsevier Limited.