resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
January, 2008, Vol. 08, Issue 01
Part IV: Chronic Problems Related to Gall Bladder Dysfunction/Disease
By Dale G. Alexander, LMT, MA, PhD
In this article, you are invited to consider the relationship between the progression of gall bladder dysfunction, migraine headaches and the existential questions of life. Chronic headache patterns often have a correlation to the cognitive dissonance of mental and emotional conflict in which one feels split, torn or confused between competing urges, behaviors or decisions in their life.
While the gall bladder is not the only organ that reacts to the stress of emotional and mental dissonance, it is among the first responders.1 And, because of its anatomic centrality, it exerts an enormous influence upon vascular efficiency, especially, I propose, upon blood flow to and from the brain.
I previously have described the body's stereotypical response to stress as a "cringing of the body's sacs and a shortening and narrowing of its tubes." The net sum of these reflexive reactions invariably includes the muscular tube of the esophagus pulling the head down and forward upon the neck. Let us remember that the esophagus has its fascial mooring to the sphenobasilar junction and therefore, may directly communicate gastrointestinal tensions from the abdomen to the craniocervical relationship (the base of the skull to the cervical spine) as its fibers shorten and narrow.2
The gall bladder as an organ is a sac as well. The stress-related effects of its cringing or resulting inflammation can neurologically provoke contracture of the right hemi-diaphragm and the lesser omentum. A shortening of these structures in their relationship to the lower esophagus mechanically adds a downward tension, further ratcheting the head inferiorly upon the neck.3 Additionally, the gall bladder tends to discharge its tensions into the spinal cord through the phrenic nerve circuit, which has its nerve roots between C3, 4 and 5.
Releasing the tensions of these cervical segments often is my first step in assisting clients with migraines. Let us remember that the nerves supplying the longus colli and capitus muscles and the scalene and levator scapulae muscles receive their neural supply from C3 and 4. Also, the neural supply for brachial plexus begins at C5, allowing for a distribution of tensions from the gut tube to be communicated to the neck and upper extremities. Contracture of and from any additional upper extremity-muscles, via their fascial relationships in sum, may further exert a downward pull of the cranium upon the neck.4
Most often, clients describe that their migraines begin as a building tension in their middle-to-upper neck spreading up and forward into the cranium, usually affecting one or sometimes both sides of their head and usually one eye more than the other. When a client reports their pain begins "within or just behind their eye" then moves backward, I request that they go back to their physician or seek further medical testing to rule out the possibility of cranial or cervical pathologies.5
My clinical experience suggests that compression within the intricate matrix of the craniocervical relationship is a significant contributor to chronic migraines. The simplest way to conceive of this is to propose that the brain gets either too little blood (ischemia) to maintain its complex functioning and starts painfully screaming for more supply; or to imagine that the compressive elements described earlier have substantially slowed the drainage of blood and lymph from the brain, creating painful pressure; thus, either ischemia or pressure build up produce the same result. And I propose they may co exist in different parts of the brain.
Earlier, I noted that gall bladder dysfunction has a potential effect upon vascular supply to and from the brain. I already have described two of the mechanisms via its influence upon the esophagus and through the discharge of phrenic neural tensions into C3, 4 and 5 that may impede delivery of fresh blood or slow the venous and lymphatic drainage from the brain.
A third proposed mechanism is the heart's inability to supply the brain and body simultaneously in the face of a congested or inflamed gall bladder, reducing the speed and volume of venous blood flowing into the inferior vena cava and then into the right atrium via the tricuspid valve.
As was noted in my last article,3 the heart's tricuspid valve acts as its primary feedback regulator of pressure and "the important factor determining the amount of blood pumped by the heart is still the rate of entry of blood into the heart."3,6 Thus, it is proposed that reduced speed and volume of arterial blood has a domino effect upon its distribution as it exits the heart through the ascending aortic arch into the subclavian, vertebral, external and internal carotid arteries and through the descending aorta. In response to the intensity of a moment or, more commonly, in response to a protracted period of the mental and emotional dissonance, anguish, confusion or conflict, the neurocirculatory regulators of the heart go on tilt, unable to equitably supply all channels. Some tissues get more blood than others - too many fires to put out simultaneously.
This assertion suggests that lack of blood flow to the brain is more likely to trigger a migraine. I harbored this assumption for many years, yet my clinical experience during the last eight years and escalating success rate in assisting clients with migraines, indicate it is blood being retained in the cranium, which tends more often to be the trigger.
How is this possible? I return to the basics of our evolutionary physiology as humans. Simply stated, the body has developed a tendency to preserve fat, retain fluids and to congest blood (when the flow has been slowed for whatever reason). The notion that the body would congest blood during a disruption of its normal delivery schedule or in response to a gradual reduction of delivery (timing or volume) is similar to how the body tends to respond to even the prospect or the actual experience of famine, by hoarding what it does have.7 This description represents a slight variation of the blocked drainage thesis proposed earlier. Nothing is 100 percent. Both the retention of blood and inadequate supply are accurate postulations within my experience, and other possibilities exist as well.
And current medical opinion is conflicted about the exact etiologies of migraines. According to a recent Mayo Clinic Health Letter, "the cause of migraines isn't fully understood."8 Thus, our clinical postulations as a profession may actually shed light on a human vexation that has lived in the shadows for millennia.
The most common profile of clients who have come to my office with migraines have been people experiencing some kind of exquisite life transition and redefining who they are (e.g., loss of long-term employment; leaving someone they truly loved in order to regain their health and/or experiencing a nasty divorce; a serious injury or illness; the death of a loved one, etc.).
Exquisite life transitions unearth the existential questions of life. They rock our carefully constructed world. And these transitions often tweak the gall bladder. Eighteen years ago, I personally experienced the theorized notion that the gall bladder consistently demonstrated itself to be highly correlated with the emotions and thought patterns of blame, bitterness and resentment proposed by Lansing Barrett Gresham, the founder of Integrated Awareness.8 He had developed his empirical model through the use of energetic touch with different body sites and specific organs relating the emotional, mental and spiritual themes of what his guests would address during, after or between appointments. Over the ensuing years, I repeatedly have confirmed these associations with clients along with many additional correlations introduced in his second book The Body's Map of Consciousness, Volume I: Movement.9
Let's consider the number of colloquial phrases within the English language that reference the human neck and cranium as a bridge to how existential questions may participate in the gall bladder's progression toward dysfunction and its relationship to migraine headaches: "You're a pain in the neck"... "You give me a headache every time I see you,"... "I get a splitting headache whenever I have to go to work/school/(fill in the blank for yourself)"... "I'm fed up to here (hand raised to one's chin)." These phrases clearly communicate elements of blame, bitterness and resentment.
To my sensibilities existential questions reflect the cornerstones of our identity - how we perceive our relationship to self and others. What do we believe in our heart of hearts is possible for us to feel, experience or achieve? Who am I now and who do I wish to become? What is my life's purpose? How do I desire to contribute to humanity? Did I choose to be here in the first place?
Quite often these foundational queries are veiled - unconsidered and unanswered in the web of a client's chronic somatic profile. I find that exploring such questions with clients is a major contribution that allows them a context for reconsidering, refining or redefining their sense of self and what is possible for them. Commonly, I encourage clients to seek out qualified therapeutic counseling to more fully delve into these queries.
Existential questions of life reflect the full scope and continuum of consciousness including whatever one considers as sacred or divine. Among the many possible there is one question that to me reflects the bookends of the continuum: Did I choose this life?
I have experienced this question to be the most important. I used to imagine this was only a question of one who lives in California. Time and experience have shown to be universally relevant. When we accept the premise and embodiment that we actually choose this life, then most of what we blame and resent others for is placed into a larger perspective of personal ownership. We more naturally gravitate toward accepting the responsibility and willingness to risk creating a life that works for us. We recognize our ability to co-create our reality and we accept that randomness exists as well. The process of embodying this premise can take some time.
The other bookend of the continuum is represented by our belief that we are a biological accident, sent back to "earth school," rejected by God or any other rationale that dispossesses us of the inherent capacity to choose and learn from the positive or negative consequences of our choices. These inevitably lead us into a spiral of victim-consciousness, feeling as though life happens to us with varying emotional flavors and behaviors of compensation, hiding, comparing one's self to others, blaming others and resenting them - making excuses for what we have or haven't done and feeling less worthy than others.
It is my personal and professional experience that we all wrestle with this alligator and others. Having specialized in working with chronic ailments, it continues to be my experience that the inclusion of a client's existential cosmology is a significant variable to the healing process. In response, clients report their awareness expands toward a more spacious possible future, one in which they perceive new choices and options for themselves. Further, the more at peace we are within ourselves, the less (I postulate) we feed the inflammatory cycles that so often are associated with chronic conditions.
It is quite interesting that in ancient Hebrew the word "reconciliation" means to "change through the gut."11 Reconciling the deep losses of life with its seeming inherent unfairness and to come out the other end without blame, bitterness or resentment is a process for which we all can experience compassion and challenge.
For the record, it's not the gall bladder per se, rather its anatomic centrality in the dance of psyche and soma that characterizes its importance. I am not proposing that if one can dial up with the right answer to the existential questions of life that they will be happy, age gracefully and won't be hit sideways by some random event. There is no inference of causation stated here, only the postulation in common sense that protracted internal turmoil participates in the stress and progression of gall bladder dysfunction and chronic migraine headaches. It is how we perceive life and what is possible for ourselves (based on our answers to existential questions) that is central to the degree to which we experience the ongoing grinding effects of degenerating stress toward various pathologies.
In conclusion, allow me to acknowledge that I have fallen short of my stated goal to be able to distill all that I wished to share in this article and to complete the gall bladder series with a crescendo. Instead, I am surrendering to how I perceive anatomy, physiology and consciousness elements work together, by sliding the focus of our attention from one arena to the next, recognizing their inherent interconnectedness and relatedness is simultaneous and ongoing as a unified sentient organism.
My next series of articles will build upon elements of this one and will describe another progression toward dysfunction/disease of similar stealth and insidiousness - one that has been anecdotally estimated to affect approximately 80 percent of the population. Stay tuned.
I wish to acknowledge Katie Truax, Glenn Gaffney, LMT, and Jake Rutherford, MD, for their editorial assistance.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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