The Doctor Is The Medicine
The heart and the five shen in the life of the healing practitioner
Gaby Hock
published in the 2nd Scandinavian TCM Congress Book September 2009

“By far the most frequently used drug in general practice was the doctor himself, i.e. that it was not only the bottle of medicine or the box of pills that mattered, but the way the doctor gave them to his patient – in fact, the whole atmosphere in which the drug was given and taken.” (Balint, M.1957).

These words rang in my mind and heart when I was still wholly untried and inexperienced at the outset of my career in acupuncture and again later, when I was first starting out as a psychotherapist. Now, some 30 years further on, I have found that these words of Balint have been proven time and again to be true in my practice, especially then when patients suffer from symptoms due to internal causes of a more psychological nature. At such times I have found that what is required of me is a therapeutical response which draws as much from my common humanity as from my learned professional skills. It is not just my own personal standing and development as a human being which come into play and are paramount then, but also the necessity to be truly present in the moment vis a vis my patient. And this entails a process of maturation through time which can of course be supplemented and furthered by professional studies, self-analysis and supervision but cannot be replaced by them.

So the question to be asked is what are we to make of this, our indwelling, natural human tendency to mysteriously engage and become an intrinsic part of the medicinal process, as Balint suggests? How can this shared inner aptitude account for our ability to bring about transformation and healing through the fact in itself of our being-present to the patient? In this article I will attempt to further acknowledge and illuminate this mystery. In doing so I will draw chiefly upon the wisdom and heritage of traditional Chinese medicine and its philosophical underpinnings while exploring the parallels in contemporary scientific understanding, and will show how these two distinctly different approaches are seeming to draw ever closer together. They each have their own characteristic language, the one being idiomatic, figurative and metaphorical; the other being logical, rational and linear. And yet each of them leads to the overwhelming conviction that the heart is central in its abounding importance if we are to thrive and prosper as fully human beings. Balint’s thesis is evocatively echoed in the following quote by Zhuang Zhi found in his chapter on ‘The Fasting of the Heart’:

“Look at this window: it is nothing but a hole in the wall, but because of it, the whole room is full of light. So when the faculties are empty, the heart is full of light. Being full of light it becomes an influence by which others are secretly transformed’. (Merton 2004)

Both quotes, one modern (Balint) and one ancient (Zhung Zhi) refer to the medicinal power within and place the way of healing before its specific method . The latter emphasises the importance of the healer’s heart, the need for ‘empty faculties’ which will result in ‘a fullness of light’, the source of all healing transformation (ling).

What exactly is meant by this will be the focus of this article. It will begin with an introduction into the physical and metaphysical nature of the heart from both an ancient Chinese and a neuro scientific perspective, and the implications for the healing practitioner. This will lead us into the anatomy of the human spirit through the eyes of Traditional Chinese Medicine: the five shen, (or five spirits or soul qualities) culminating in the spirit of the earth element yi, intention, and Sun Simiao’s famous quote: those who know how to use intention are good doctors.

The heart

Cross-culturally the heart is seen as our vital centre, emotional, moral and spiritual core, sacred vessel, holy land of each being, the seat of the soul and of human virtue. In the Chinese tradition, the Huangdi Neijing says that the heart and the mind are one and the same organ: xin = “The heart is sovereign master, the shining radiance of the spirit (shen) and clear insight (ming) stem from it”.

“Always tempted to fill itself, the heart needs to seek emptiness, so that the radiance of the spirit can shine through it.” (E. Rochat de la Vallet 1996).

The Clinging – Fire:
The Image:
That which is bright rises twice:
The image of Fire.
Thus the great man, by perpetuating this brightness,
Illumines the four quarters of the world.
(The I Ching 1951)

This refers to the illuminating power of the sun and its radiance which gets perpetuated through the “great man who continues the work of nature in the human world. Through the clarity of his nature he causes the light to spread farther and farther and to penetrate the nature of man ever more deeply.”
(The I Ching 1961). In Chinese thought, this emanation of light is administered through the human heart.

Contemporary science

Contemporary science no longer views the heart as a mere pump, but an organ with its own intelligence, its ‘own brain’, i.e. a nervous centre capable of learning, remembering and processing information. With an electromagnetic field 5000 times stronger than that of the brain, the heart is the most powerful oscillator in the human body. When the heart beats, it sends out pulsing waves of energy that interact, instruct and inform, i.e. give shape to every organ and every cell in the human body. (McCraty 2004-2005). It is also now confirmed that these pulsing waves are under direct influence of our thoughts and emotions; a fact which the Chinese knew 2000 years ago. Since these energy waves radiate beyond the body in a radius of up to 6, even 10 feet, the heart is not only central to our own lives but also has social implications as it bears huge significance in our interactions with others.

At a conference about The Relational Heart in London in 2008, scientists confirmed that when we experience ‘core heart values’ such as love, appreciation, gratitude and care, our heart rhythms, (i.e. the sine waves on an electro cardiograph), become significantly more smooth and coherent. This initiates a cascade of neural and biochemical events that effect every organ and cell in the body, including the brain. When there is heart coherence induced by positive feelings, brain functioning improves, we can think more clearly, and the entire immune system gets a boost. There is no energy wastage because all systems work harmoniously and coherently at a level of maximum efficiency. This keeps us young and promotes a sense of well-being and a long and healthy life.

Conversely, when we experience continuous stress and anxiety or other negative emotions, heart rhythms become jagged and chaotic. This in turn gets communicated to the tiniest cell in the body, impairing hormone, immune and nervous functioning which, when experienced over long periods of time, will lead to all sorts of physical and mental illness and eventually to systems breakdown.

This understanding changes the whole idea of heart cultivation from the idea of being a charmed, esoteric pastime to a health imperative of the first order. Stress is the enemy, while core heart values such as appreciation, gratitude, care and love are the heart’s greatest friends. Those who are the friends of the heart are friends on all levels. Those who are the enemies of the heart are enemies on all levels.

“By following heart values we get closer to a sense of true security and a feeling of belonging that we all crave for. Numerous studies show that feeling loved and cared for, along with caring for others around us, plays a greater role in increasing our health and longevity than physiological factors such as age, blood pressure, cholesterol or smoking.”(McCraty 2004-2005)

In addition, it makes our perceptions more accurate, deepens our heart's intelligence and gives us clearer awareness of the world around us:

“One person’s brain waves can actually synchronize to another person’s heart. Furthermore, when an individual is generating a coherent heart rhythm, synchronization between that person’s brain waves and another person’s heartbeat is more likely to occur. These findings have intriguing implications, suggesting that individuals in a psychophysiologically coherent state become more aware of the information encoded in the heart fields of those around them. This capacity for exchange of energetic information is an innate ability that heightens awareness and mediates important aspects of true empathy and sensitivity to others. When our heart rhythms are balanced, our outlook and perception is more positive, difficulties cannot get a grip on us as we can see a much wider range of solutions to problems.” (McCraty R. 2004-2005)

Traditional Chinese Medicine

All of this adds weight to the ancient proverb ‘Doctor heal thyself’. It is a reminder to anyone in a healing or caring capacity to cultivate heart coherence. When there is heart coherence, we are naturally more joyful and compassionate, the mind is more quiet and discerning and our perceptions more astute. This gives the doctor a greater capacity for diagnostic accuracy and appropriate healing intervention.

In Traditional Chinese Medicine this heart-mind-spirit-consciousness capacity is called ‘shen' - or simply, spirit or spirits. The radiance of this spirit is called ‘shen ming’. It resides in the human heart (xin), which is regarded as the ruler/emperor of all the other organs (zang fu). Because the task of shen is so huge, the heart has subcontracted other organs to carry out different shen functions. The heart is like the sun, its rays are the radiance of the spirit which is beamed throughout the entire human body and mind, where it infuses every single cell with light, intelligence and consciousness. At the same time there are very specific shen or ‘light tasks’ to be carried out. For these, particular organs have been selected like government ministers.

The five shen

One could say that the five shen are the constituents that make up an individual’s intrinsic nature. Essentially, their five divisions are one unified interdependent reality which are representative of what we might call ‘the Self’. They are the subtle, precious forces behind the perceived universe, which direct and determine our life. To fully embody the five shen, we as healing practitioners need to develop and expand our cognitive, intuitive and kinaesthetic awareness, which is facillitated by the ongoing endeavour of getting our own emotions into balance and with that a mind that is under our control, rather than a mind that controls us. That way the subtle and elusive nature of the five shen become more potent, embodied and grounded in our everyday lives and in our healing practices.
“Gaining shen means gaining and blossoming, losing shen means perishing.” (Larre C., Rochat de la Vallee E.1995).

Here follows a brief summary of the five shen and their associations:
Shen is the overriding principle of light and intelligence (heaven) seated in the human heart/mind and associated with the fire element. Its polar opposite is zhi = willpower, motivation and drive is seated in the kidneys, associated with the water element. To the one side is hun, the human soul, responsible for intuition and imagination, also called the etheric or wandering soul, seated within the liver and associated with the wood element. To the other side we have po – the corporeal or animal soul, which is responsible for the awesome intelligence of the body, seated within the lungs and associated with the metal element. In the centre we have yi -intention, the power of the intellect, seated in the spleen, associated with the earth element.


Finally for the purpose of our discussion on The Doctor Is The Medicine, all five spirits gather as one in the centre of the earth element and the doctor’s everyday clinical reality. Here in service to the patient, the spirit, the will, the ethereal soul and the corporeal soul become medicinally efficacious via the power of intention – yi. This is the doctor’s medicine. It echoes Sun Simiao’s famous quote that medicine is intention and that those who are proficient at using intention are good doctors.

“Yi is the ability to enter into the totality of a clinical situation, view it from different angles simultaneously, match it with ideas already present in the mind, compare and contrast them, weigh up different possibilities for action and then, only then, do what is appropriate”. Yi is therefore a form of intelligence which comes from knowing….and manifests in doing. (Scheid & Bensky 1998).

The Chinese character for intention represents a mouth and sound. It refers to the sound that a person makes through the words he/she utters. But it goes even further: ‘Yi are the thoughts invoked in the mind of the listener who listens to the words of the speaker’ (Lorenzen & Noll 1996). In an ideal world, the sound of our words should therefore have a ‘heavenly vibration’, at which point a healing practitioner becomes a shen yi, a divine practitioner, a shaman or a medium receptive for the magical healing power of the cosmos. It is that cosmic healing power
which inspires and directs our diverse healing methods, whether they are needles, pills or words or the powerful act of simply being present.

There is always a danger that we become merely users of a skill rather than people who are responding from the centre of our own mystery, from our own wholeness, to the mystery of another person.’ (L.Freeman )

Gaby Hock


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