Help with a case

[Anna Bordas]

Hi everyone,

A patient came to my office for lumbar pain, migraines and for helping her wit her depression. The main reason was the lumbar pain which it has been there for many years. She is 53. Se said that she has de depression since she was 12-13 years old. In fact, she explains that all the photographs she has from her childhood, she appears with sadness in her face. She has a trauma so when she was 7-8, one day arrive at home and she found her mother lying on the floor bleeding from a molar pregnancy. In that moment her feeling was that she was loosing her main support in the family. She said she has always felt very lonely in her childhood and took refuge with the animals that were in her house. his father was very dominant and says he abused his mother psychologically.
Her mother died last year from a cancer. Since then she feels very lonely even if she is married and she has a daughter. She has a good relationship with her family. She has a very bad feeling with her father. She refers that every time she visit her father,”he takes all her energy” and when she leaves she feels very tired and it seems that he become stronger. She talked with her father many times and she understood a lot of things but she really hates him and she can’t forgive him.
I’ve been treating her with the 8x’s. I started with Yin wei Mai to try to let go the past and because is what I found on her pulses and I use sinews to release the Tai Yang I treated her with the Chong Mai (1st and 2nd trajectory) because she has a kidney yang and a spleen deficiency and to let her express all her feelings so I think she can’t do it, she said, she never cries. Moreover she had a surgery of the left thyroid.
The pain improve a lot. Actually I can see that she changed a lot. But may be there is something that I’m missing because the lumbar pain doesn’t disappear at all. And the bad feeling with her father is really strong. Nowadays I’m using the Yin Qiao Mai because from the last month her pulses are very profound, actually when you firstly take the pulses you don’t find anything. After a while you feel the pulse on the guan position, but it’s very deep. So I read on the Ann’s book that it can be Yin Qiao. Sometimes I mix the treatment with sinews because she has still migraines and it seems that they are working. I perform TH an LI because I think that the migraines appear from tension and bruxism.
I would like to ask you your point of view so in my opinion i think that there is still something to break out and maybe, finally the pain will disappear.

Thank you!

Anna

[Armin]

Hola Anna!

Hope you are well. I think you are already doing great and clearly she’s getting better. But as you say her anger towards her father is still very raw and strong, so that might be one possible connection. Perhaps she is holding that anger in her lower back or the the anger is depleting her Kidneys given that she feels all drained after seeing her father.

Seems to me some luo treatments might be in order to release this anger towards her father, but of course, she would want to let go of it too, in the first place. Some forgiveness on her part might be needed for her to get over this obstacle.

Armin

[Lois Nethery]

Hey Anna,

I mirror Armin’s comments – both that you are helping her a lot, and also to consider the Luo.

My first thought while reading was UB Lou, as the primary channel runs through the lumbar area and it is excellent for relieving stagnation of PTSD / trauma.

The Luos eventually empty into the Qiaos so it’s possible that this is why you are feeling Qiao pulses now.

I look forward to hearing other ideas and also would love to hear how she progresses.

Lois

[Mònica Martín]

Hola Anna,

It sounds like a very interesting case and that you’re doing very well. Chongmai appears as prominent channel and you actually worked with the first and second trajectories already. Also Yin Weimai can help to move on in this scenario which also may pave the way for a deeper work with the first ancestry.

The 2nd trajectory of Chongmai features the Kd shu points on the chest. When needling this channel if you step back and look at your patient you will see that it very much resembles a cage. Very often, people who have issues in this trajectory have a history of trauma pressing deep in the chest more or less literally, and often the person reports a sensation of being “imprisoned” in a cage (the rib cage) by a feeling that could be hatred, sadness… “imprisonment” stems from the believe that there’s an issue that have not been and will never be solved. Sometimes the person doesn’t even have know “consciously” why he feels as he does. This is the source of an underlying frustration (blocking of creative energy –Lv Qi stagnation) that overtime leads to depression (Lv Qi xu). Your patient seems to have gone into shock from seeing her mum on the floor bleeding, and at that time she feared that she might lose her (and the support she represented for her) and she “blamed” her dad for that. The recent death of her mum could have awakened the memory of those feelings in the past and increase the stagnation that was already present.

It is interesting to see that patients experiencing trauma affecting this layer often report difficulty in talking about it. That often creates a great deal of stagnation in the throat which can affect the thyroid, a problem for which your patient needed surgery. Tiāntū 天突, Ren22, Celestial chimney, “opening up the chimney” (the sternum) to let the “smoke” of what is being burnt (Shen – Ht – Fire element) reach the Heaven (head) so it can travel through the throat to reach the root of the tongue via Liánquán 廉泉, Ren23 Ridge at the Spring, so emotions can be freely expressed through the tongue, and also to cause a cathartic release through the tears in the eyes, Chēngqì 称泣, St1, Container of the tears (difficulty in crying that your patient reports). This trajectory features a Luo pt, Nèiguān 内关, Pc6, the Inner Gate, that releases the chest by “opening the cage” and freeing the emotions trapped inside. Kidney shu points can be needled either according to the Element they represent, or by considering their single point energetics or just by palpating and locating the most tender points. You can correlate both findings and often you will find that the point you would choose happens to be the most tender point/s. In any case, the patient ended up expressing all those feelings to you, so you must have needled the right point!

Gōngsūn 公孙 Sp4 already infers the generational theme that often underlies many of our most deeper conflicts generally dating back to the mother and father figures. Unblocking the 2nd trajectory of Chongmai may help you address deeper fundamental Renmai issues related to the absence of bonding (specially to the mother figure) and the sense of sadness that can result of it. Lu7 opens Renmai but it is also the Luo point of the Lung channel that can beautifully address these problems. Yet, for this patient the absence of bonding was rooted in the first cycle of 7-8 and so a Renmai treatment is particularly indicated specially if pulses also point to it (not only Yin Qiaomai, but Renmai also may yield deep moving pulses that cannot be felt when pressed down).

Lumbar pain could be related to fear/anger blocking the natural expression of the Dumai energies, the father figure, whose relationship and the conflict inherent with him seems to be unresolved as Armin was pointing out. Hence Dumai energies and that which they represent (the father) seem to be blocked, and that might be the trigger for the lumbar pain. Have you considered the third trajectory of Chongmai? Yang energy stems from Dumai. If a Chongmai issue blocks the ascending distribution of Yang through Dumai, lumbar pain may result as well as other functions related to keeping things in place. If the Sea of Yang is blocked there may be issues related to energy (tiredness) and Spleen and Kidney Yang deficiency (prolapses, GI issues…). Every time she meets her dad she feels like “he takes all her energy” because that’s when she confronts her main conflict with him (anger, frustration => stagnation => blockage). Possibly her lumbar pain worsens too, and you can treat very rebel lumbar pain issues with this channel. This trajectory features BL17 which treats stagnation of Qi and Blood and unblocks the diaphragm. Resistance to forgive her father suggests that there might be some rigidity in the patient that this channel could help to reduce by addressing the stagnation in the Liver due to Cold or Liver Blood deficiency that may be causing her migraines and lumbar pain. Chángqiáng, 长强 Du1, Long resistance would be an important point to address this rigidity. Gōngsūn 公孙 Sp4 here again features as a reminder of the generational conflict underlying your patient’s problems. And particularly the problem with the father, in this case.

Have you treated or even considered this trajectory before, Anna?

Apart from the deep pulse, what made you think of Yin Qiaomai? What’s her tongue like?

Keep us updated,

Una abraçada

[Anna Bordas]

Hi Armin, Monica and Louis,

Thank you for your answers. Since my message I’ve performed the luo bladder and the Ren Mai to work with the trauma when she was in then first cycle of seven. I found lots of vains in the bladder channel, in fact, the patient told me that she had been operated about varicose vains in the lower limbs (bladder’s channel zone).
After these two times the patient reports that know she doesn’t shut up…she replies if she has to do it. Her husband says the is getting worse because she seems to be angry all the time. In my point of view now she expresses everything she feels regardless of the consequences. She only needs to dare answer his father because she is still not ready.
I’ve treated her with the chird confluence of the Chong Mai when I was treating her with the Chong. Yes, I considered this because of the lumbar pain. I’ve worked the Chong a lot.
Answering your question Mónica, It made me think of Yin Qiao Mai because of her tiredness, the lack of enthusiasm… She alaways want to rest at home because she is afraid of being bad the day after she goes out. It seems that she is assleep all the time…I’m not sure If I’m right or not.
About her tongue. It’s pale, it’s a white coated tongue. With dental marks. She refers to have fungus on the tongue but I’ve nerver seen them. I don’t know if she related this with the white coated.

I’ll see her tomorrow. I’ll keep you posted.

Thank youuuuu!

Anna.

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