When was the last time you were frustrated by the slow progress your client was making in regard to his or her ongoing back pain? Or when was the last time your treatment of chronic migraine headaches offered only temporary relief? Frustration need not set the tone for your clients’ pain management. For pain relief for my clients, I utilize an ancient acupressure technique based on Chinese acupuncture and Daoist medical philosophy that has produced phenomenal results.
As an acupuncture physician, massage therapist, and continuing education provider, I have been exposed to a lot of ancient Chinese acupressure and medical massage techniques, especially as China opened up to the West in the last decade or so. Like many acupuncture physicians and massage therapists, I was taught traditional Chinese medicine (TCM) when I went to massage and acupuncture school in the 1990s. It was only much later, through some visiting Chinese acupuncture masters, that I was exposed to the Daoist way of thinking and achieved a breakthrough in my clients’ treatments.
What is Daoism?
Daoism means the “path” or “way” and refers to a mixture of philosophy and religion. However, it is not an isolated and esoteric practice. The principles of Daoism are intertwined with Chinese cuisine, traditional medicine, feng shui, astrology, immortality beliefs, martial arts, and various styles of qigong, with an emphasis on the natural order of things and behaviors. There is no worship involved and no particular sect subscribes to its teachings.
Daoism describes the flow of force through the universe, or the flow of qi (chi) behind the natural order. Qi is the essential life force that is the source of our existence. In Daoism, man is not separate from the universe or nature. Instead, humans are a microcosm of the universe and thus follow its universal laws. The five-phase or Five-Element Theory (wood, fire, earth, metal, water) is based on Daoist philosophy, and the theory of yin and yang (complementary opposites that oppose and support one another) owes much to early Daoist Chinese doctors.
Systematic Correspondences
One central principle in Daoism is the system of correspondences, which explains much of the medical and religious beliefs inherent in the Daoist practice. The concept is so important that the famous German sinologist Paul Unschuld called Chinese medicine the medicine of systematic correspondences. These are correspondences are contained in the classic Chinese medicine text that translates in English to The Yellow Emperor’s Classic of Internal Medicine. For our purposes here, we’ll call it the Emperor’s Classic.
According to the Emperor’s Classic, “Humans correspond to heaven and earth and should follow the four seasons. They are in conformity to heaven and earth.” The text also extends this theory of correspondences to the domain of human biology and medicine. For instance, the Emperor’s Classic says: “When the sages stipulated measurement, they must have considered the correspondence to heaven and earth. Therefore, as there are constellations in heaven and there are rivers on earth, so the human being has channels and vessels.”
Within the text, there are even more detailed descriptions of similar correspondences: “Heaven has four seasons, while human beings have four limbs … There are 365 days in the year, while humans have 365 joints (or acupoints) … There are 12 channel rivers across the land, while humans have 12 channel vessels.”
Utilizing the Correspondences
We see a similar approach of correspondences in shiatsu-anma, which is indirectly derived from Chinese medicine. The principles here are supplementation and drainage. You supplement or strengthen when there is emptiness or vacuity (insufficient qi or life force) present in the client. You drain when there is overwhelming energy, or what the text calls “staleness”—stagnation and congestion over lengthy periods of time. A Western massage analogy is myofascial pain evidenced in trigger points. These trigger points contain surplus energy, in most cases, that has to be drained and redistributed. Any insufficiency of energy, as evidenced by fatigue, has to be supplemented.
The four seasons are times when the qi or universal life energy of the client is in a state of ebb and flow. We often find ourselves, and our clients, at peak energy during a particular season and bottoming out in another. The Emperor’s Classic also mentions that such seasons are in opposition to one another, but not exclusively so. This can be the case for someone who finds that he or she has abundant energy in summer and little or no energy in winter. But what is the connection?
Let’s take the case of Jane, a fictitious client, who will represent the cyclical relationships of energy. In the summer, Jane feels like getting up every morning and performs many long-term projects. She is also much more mentally alert and enthusiastic about life. However, all that energy takes a lot out of her. So when winter comes, her body and mind slow down as they store and replenish energy. Then, when summer comes, she is at her peak again. Therefore, as a massage therapist, you should do massage or acupressure for Jane that drains and relaxes her in summer. In winter, you do the opposite. That way, she is in harmony again with nature and the universe.
Daoist Techniques
Acupressure techniques are the same as acupuncture techniques, without the needles. This work is best explained by using the famous Tai Ji yin/yang symbol of cyclical relationships (Image 1). This symbolic representation will also clarify our client Jane’s pattern of energy.
The light or white color in the Tai Ji represents yang energy or fire. Fire symbolizes light, heat, and activity. This represents the functional part of the human being. In terms of human biology, yang symbolizes the physiology of the human being. The black or opaque color symbolizes yin energy or water. Water symbolizes dark, cool, and passivity—everything that is opposite to yang.
Notice the four segments into which cyclical time has been divided. The top of the symbol describes the peak of yang. During the height of summer, or at noon, is when light, heat, and energy are most abundant. This is a time when activities and thoughts (the mind) expand. By contrast, the bottom of the circle describes the bottom level of energy. Here, during winter, and at midnight, is when darkness and cold are at their peak, while energy is at its lowest point. Activities and thoughts contract or shrink during this time. Also, notice how yang energy flows in a clockwise direction.
So in the summer, Jane has the energy to think and act as if all activities are long-term. In the winter, Jane always feels spent and tired, therefore it’s in the winter when Jane needs to conserve energy. What about spring and autumn? Spring represents the rise and growth of natural energy toward summer. Autumn, on the other hand, depicts the falling and shrinking of natural energy, as the body prepares to shut down and replenish in the winter.
As an acupressure therapist utilizing the Daoist philosophy, I may place my thumb, finger, or whole hand on a key acupressure point, or ashi point, that is painful and rotate to the left or counterclockwise, if there is excess energy causing pain. If I want to release and sedate, I will go against the flow of yang energy. First, I have to make sure that the pain is musculoskeletal or myofascial and caused by excessive strain. If the pain, however, is due to a tumor or organ, a deficiency might be causing the pain.
When I want to energize and strengthen the client, I rotate my movement on the acupressure point clockwise. The length of time holding the acupressure point is dependent on the condition of the client and his or her constitution. Chronic conditions take 2–5 minutes, while acute conditions can take 20–30 seconds to have an effect. Is there pressure involved in this action of regulation? Yes, but pressure applied need not be excessive. On a scale of 1–10 (from lowest to highest), pressure can be anything from 2–5. The therapist has to respect the pain threshold of the client, but also be guided by the intent of the therapy. It’s all about modulating the energy of the client. The intent is not to squeeze out the painful point, creating a situation of good pain, but instead to create a circuit between client and therapist. By being non-confrontational and using pressure on a scale of 1–10, you allow qi energy to flow from the universe through you and into the client, thus creating a circuit. However, the therapist also visualizes or intends this circuitry. Those practicing qigong meditation will be familiar with the concept of visualizing the qi flowing.
In the second Tai Ji image (Image 2), pain derived from excess yang, or energy that is invading yin, is represented in the more skewed image. Yang can represent two signs of inflammation—heat and pain. Notice how the yin on the right, representing coolness, relaxation, and no pain, has diminished in this example.
But what do the two small circles, one black and the other white, mean? As mentioned earlier, Daoists believe that the two concepts of yin and yang were complementary but opposite. When you look at the Tai Ji symbol of cyclical relationships, you notice that the two curved parts in the diagram are like two fish of opposite colors lying in opposite directions. This suggests that the two parts composed of everything are different in nature and move in different directions. However, even if they are opposite, they share the same circle. This implies that there is unity between the two opposite poles in anything. In the illustration, the yin (black) fish has a white eye, whereas the yang (white) fish has a black eye. This means there is yin within yang, and there is yang within yin. One engenders the other. In Image 2, even if the pain is extreme, the yang condition still has in its nature to embrace the yin aspect. The dividing line between yin and yang has no space between it, meaning that the yin and yang fish embrace one another within the circle.
According to TCM, the skin is described as yang, while the inside tissues and organs are described as yin. One has to remember that yin and yang also represent opposite energies, like that of a battery, except that this energy is not the electrical energy we find in the nervous system. Scientists talk about this energy being a biomagnetic force, or qi. Yang represents positive energy and yin represents negative energy. When the therapist presses the acupressure point on the skin, he or she is connecting the positive yang on the outside with the negative yin on the inside of the body. Since opposites attract, we have an energy circuit.
Daoist Pain Management
In terms of pain management, the Daoists believe in a rule of opposite correspondences based on a mirroring format. The mirroring format is designed to specify which part or parts of the body reflect tenderness or weakness distal from a “sick” area. If the knee is sore and has myofascial pain or arthritis, then the therapist mirrors that body part on an elbow that is most distal to the “sick” knee. That would be the opposite elbow. If the knee is sore on the outside, then the therapist looks for a corresponding area on the lateral side of the opposite elbow. The exact acupressure point location is found by checking for an experiential sore point on the elbow. An experiential point is an acupressure point that falls outside the normal established path of the meridian. It might even be on the meridian and not an official acupressure or acupuncture point. However, the past experience of countless acupuncture doctors from China who use the Daoist system has shown that it is a valid acupressure point because it corresponds to the sore or sick area of the knee.
In almost all cases, the mirroring format balances an upper limb with a lower limb and vice versa. The limb, in this context, includes all parts of the limb such as fingers, toes, wrists, ankles, elbows, shoulders, and hips. For example, if the injured area is the upper arm, the opposite hip is selected. If the pain is on the lateral side of the middle deltoid, then look at the area of the vastus lateralis or the iliotibial band. It is important to pinpoint the area of pain first on the shoulder, and then select the sorest corresponding point or points on the lateral side of the leg.
Once you have located the sorest point, get the client to move the affected limb opposite to the area you are working. Keep on working that area without increasing the pressure. The movement of the affected limb pushes the stagnant qi through the affected meridians—the three-dimensional channels through which qi flows to all parts of the body—and therefore through the fascia and muscles. Again, there might be more than one sore point.
There are rare cases where the ipsilateral side to the pain has to be chosen. That is why the therapist must palpate both sides and choose. Usually, in the case of myofascial/musculoskeletal pain, the contralateral side corresponding to the affected part will be more sensitive to palpation. Only in rare cases will there be a response by palpation on the same side as the pain. There is no explanation for this, according to Daoist bodywork. The therapist must palpate both sides for a response.
Balancing Yin and Yang
It’s hard not to notice that the technique of balancing through opposite correspondences can also be visualized through the Tai Ji symbol. According to Daoists, the left of the body is yang and the right is yin. Yang represents the male aspects of the human being, which means the acupressure therapist should start on the left side of the male body. All emotional issues, like anger, fear, worry, sadness, and joy are functional aspects that involve an output of energy and are therefore described as yang. Yin represents the female aspects of the human being. Traditionally, women have mostly yin-related issues that have to do with blood, lymph, and all the fluids. These are structural issues. In this case, the therapist starts on the right side of the body.
Also, the area above the navel is described as yang, while the area below is described as yin. The root of the pain can be in myofascial issues that stem from unresolved emotional issues causing stress. However, the therapist might find the location of the painful injury on the yin side of the body in a male client, simply because that side was weakest. The emotional stress of the pain can still be treated on the left, or yang, side of the body for purposes of balance. Also, because of the hectic and stressful pace of our modern lifestyle, women can also come to the therapist primarily with emotional issues. Thus when applying the rule of opposite correspondences, one is also helping to balance the yin and yang of the whole body.
a higher order
The Daoist system of correspondences is a structured, goal-oriented modality that achieves permanent pain relief and deep healing in a most economical manner. Not simply a technique, its roots lie deep in ancient philosophical principles. The massage therapist has to then realize that myofascial pain and musculoskeletal issues are symptomatic of a fundamental imbalance in the mind-body connection of the client, who has “violated” an ancient philosophical principle of order in the universe. Only when practicing the Daoist acupressure technique can the therapist also gain respect for the power of qi in its many manifestations and see himself or herself as part of a higher order of things.
Wolfgang Luckmann, LMT, is an acupuncture physician and Diplomate in Homeopathy. After graduating from the Florida College of Natural Health in Miami, Luckmann attended the College of Acupuncture and Massage and graduated with distinction. He has brought 20 years of teaching experience to his numerous holistic continuing education courses. He teaches nationally to massage therapists, acupuncturists, and estheticians on subjects ranging from Indian head, foot, and face massage to addressing fibromyalgia, chronic fatigue, and depression with the East-West Synergistic Massage. For more information, contact Luckmann at wushebang@comcast.net.