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Acupuncture And The Chakras

Michael Greenwood, MB (MD) ABSTRACT The concept of chakras is not generally considered part of the acupuncture paradigm. Yet like the acupuncture points of Chinese medicine, the chakras are energy nodes with specic functions and correlations. The author suggests that a familiarity with the chakras can be a useful adjunct to medical acupuncture, and interested practitioners can nd simple ways of integrating concepts of chakras with traditional acupuncture theory. KEY WORDS Acupuncture, Chakras, Kundalini, Energy Field, Chong Mai

INTRODUCTION Most acupuncture practitioners are familiar with the term chakras, the energy centers of Vedic philosophy and Ayurvedic medicine. But, since they arise from another tradition, there is little mention of chakras in acupuncture texts nor conversely, much talk about acupuncture in books on chakras. However, a cross-referencing of acupuncture theory and chakra-based theory can be clinically useful. For example, consider how closely this description of shakti, prana, and nadis resemble the Shen, Qi, and acupoints of Chinese medicine: ...She (Shakti) becomes the ve elements and combines them to make different forms...She makes the body consisting of seven constituents and 72,000 nadis and enters it as prana. She is present everywhere in the body in subtle form. There She causes prana to move through the nadis at lightning speed. She circulates blood in a systematic manner...1

medicine. Meantime, the prana, like the Qi of Chinese medicine, runs in channels or nadis, perhaps similar to the acupuncture meridians. Chakra Location and Classication The names of 7 chakras are listed in Table 1. Note that the Ayurvedic and Chinese elements are not the same. This is indicative of the fact that the symbolic meaning of the elements in each tradition does not necessarily correspond. The acupoints too are not direct correspondences, but only best-guess approximations based on similarities of chakra and point locations. The Personal (Ego) and the Transpersonal Chakras can be categorized as a trinity of lower, middle, and upper, which refer to the physiological (ego), soul (Heart), and spiritual (transpersonal) levels. Conceived of this way, an interesting symmetry becomes apparent: in both the upper and the lower grouping, specic chakras reect the principles of the void (Tao), individuation (agency or Yang), and connection (communion or Yin). The lower 3 chakras reect these themes as they relate to the personal or individual ego while the upper 3 chakras reect the same themes as they relate to the transpersonal (Figure 2). Meantime, the Heart, as the sovereign of the body-mind-spirit and container of the Shen, functions to integrate the personal and the transpersonal into a unied whole. Many people live from the rst 3 (lower) chakras, never accessing the transcendent resources of the Heart and upper centers. Yet the possibility of opening to them is always present and may be actualized through a creative encounter with illness in which the ego becomes aware of and learns to channel the transpersonal energies immanent in the illness symptoms. The beginning of such a transformational process has been described in Chinese medicine as passage through the Golden Gate.4

Figure 1. The Energy Field

WHAT ARE THE CHAKRAS? Modern physics has revealed that beyond the superficial appearance of structure, the universe is an innite vibrating energy field, which is organized according to harmoniously resonating intervals.2 Similarly, beyond its superficial material structure, the human body has an energy eld that has maximal intensity in and around the physical body, but which extends outward into space toward innity, albeit with diminishing intensity the further out one goes.3 The various energies owing in and around the body vibrate at their own frequencies and resonate harmoniously at nodes, known in Ayurvedic medicine as chakras and marmas. Although different sources describe varying numbers and locations of these nodes, there is a general consistency about the 7 major nodes that run down the center of the body (Figure 1), while the more numerous marmas might well correlate with the acupuncture points of Chinese

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The reception and channelling of transpersonal energies is generwholeness reects an integration of the personal and transpersonal, the ally accompanied by an attitudinal shift in which the egos customary individual and the transcendent, through the mediating faculties of the stance of alienation gives way to a sense of universal interconnectedHeart. In addition, although the symbol comes from Asian traditions, ness. Koven states: in Chinese medicine, the image of overlapped triangles can be traced back to the Book of Changes (700 BC), while the image of three upon At higher levels of the I-continuum, Consciousness is three forms the basis of the hexagrams of the I Ching. Then again, in both self-aware and aware of its interrelationship with every Western tradiions, it shows up in the Star of David. It is very much a part of the Universe. All existence is holographic, each part transcultural image. containing the imprint of the whole and each affecting the If the triangle with apex pointing downward is taken as the symUniverse in intimate and extraordinary ways.5 bol for the Water element, while the triangle with the apex pointing Despite its philosophically holistic underpinnings, acupuncture as upward is taken as the symbol for the Fire element, then the image of it is customarily practiced uses dualistic diagnosis/treatment protocols overlapping triangles exactly mirrors the Chinese medicine concept of and therefore, remains largely an ego-level intervention. At this level, the Heart-Kidney, Fire-Water axis. energy may be tonied, sedated, or otherwise moved around, but the underlying gestalt, which gives rise to the illness state (which lies in I. The Root Chakra Mulahadara the ego's sense of separateness), often remains unchallenged. FurtherThe rst chakra is said to be located at the base of the spine just below more, even if temporary symptom relief is achieved through such a prothe coccyx, behind the anus, and is described as a red lotus with 4 petals. cess, without a concomitant integration of the emerging transpersonal Chinese medicine describes 2 points in the area: GV 1 (changqiang), energies, the acupuncture ritual risks becoming addictive. The result located behind the anus at the base of the spine, and CV 1 (huiyin), may be little more than a change of dependency from one therapy (perlocated in front of the anus. CV 1 is regarded as the most Yin place on haps drugs) to another (acupuncture). the body and therefore a source of primal Yin energy. Similarly, Taking acupuncture beyond the ego-level requires the development Ayurvedic medicine conceives the root area to be the source of a priof non-dualistic models. Sankey, for example, has explored esoteric mal energy known as Kundalini. acupuncture using models spanning the Qabbala, chakras, and sacred In the Vedic tradition, the root chakra is associated with groundgeometry.6 Every model has its merits, but the chakra system is so simedness, connection to the Earth, and the instinct for survival.7 Because ple and well-known that it almost begs to be included in an acupuncof this elemental association, it is tempting to associate the root chakra turist's toolkit. Furthermore, the model makes it visually clear that there with the Earth element of Chinese medicine. But, perhaps the Water are energy centers beyond the ego level and implies that an aspirant element makes as much sense. Undeniably, the sense of grounding/ looking for healing needs to explore these upper centers as part of the centering of the root chakra may well relate to Earth, but the notion journey to health. of a deep potential out of which things arise and manifest is more in However, doesnt the Five-Element model address this issue? Pertune with the Water element. Those who cannot mobilize their root haps not. The Five-Element system describes personality characterenergy often spiral downward into a life of invalidism, as all their availistics that, by denition, are energetic tints through which an alienated ego views the world. Table 1. Chakras and correspondences In contrast, a fully integrated inSanskrit Ayurvedic English Chinese dividual sees the world as it is, Name English Element Acupoints PinYin Translation Element without the trace of a tint. ConMulahadhara Root Earth Front CV 1 Huiyin Meeting of Yin Water sequently, although the FiveSupport (Earth) Back GV 1 Changqiang Long Strong Element model may be capable Swadhisthana Your own Water Front CV 4, Guanyuan Origin Pass Earth of facilitating the healing journdwelling CV 5, CV 6 Shimen Stone gate (Water) ey up to the edge of the ego or origin Qihai Sea of Qi boundary (symbolized by the Back GV 4 Mingmen Gate of Destiny Golden Gate), successful traversal Manipura The city of Fire Front CV 12 Zhongwan Central Venter Wood through the gate involves sacrithe shining ficing the tint. Consequently, Back GV 6, Jizhong Spinal Center jewel GV 8 Jinsuo Sinew Contraction what happens thereafter must, by denition, transcend the Five Anahata That which Air FrontCV 17 Danzhong Chest Center Fire Elements. The chakra system can is ever new BackGV 11 Shendao Spirit Path give us a glimpse into that world Vishuddha Purication Space Front CV 22, Tiantu Heaven Metal beyond the ego boundary, beST 9 Renying Rushing Out yond the Golden Gate. Man Welcome The upper and lower chakras, Back GV 12 Shenzhu Body Pillar depicted as triangles with their Ajna Command No Front GV 24.5 Yintang Seal Hall No element apices directed toward a central element Back GV 14 Dazhui Great Vertebrae Heart integrator, are shown in Figure 2. Note that the symbol for Sahasrara Universal No GV 20 Baihui Hundred No element Selfhood element meetings the Heart chakra (Figure 3) is a condensed form of this same image. The symbol implies that
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gins to ow up the spinal column through 3 energy channels, or naable energy lies stagnant in the 1st chakra. Such people, expressed symdis, to open the higher chakras in succession. bolically by the out-of-balance Shao-Yin Water biopsychotype, can nd life a constant struggle and sometimes live in a chronic state of being The rst of these channels, Sushumna, is the central column and overwhelmed, never able to get moving in life.8 perhaps corresponds to the Chong Mai. The other 2, Ida and Pingala, are depicted by the 2-coiled serpents around the Sushumna, and may Both Water and root are concerned with deep personal resources represent the Du Mai and the Ren Mai. Although the correspondences and unmanifest potential. When illness arises in those so predisposed, are not exact, Ida is said to carry cool lunar, Yin energy, and might be the area around the root chakra is a frequent locus for stagnation to said to correspond to the Ren Mai. Conversely, Pingala is said to carry occur. For example, common problems might include low back and warm, solar, Yang energy and could be said to correspond to the Du Mai. sacral pain, hemorrhoids, constipation, or prostate difficulties. Related symptoms may overlap into the 2nd chakra, manIt should be noted that Sankey and others ifesting as lumbar discomfort or sexual hyper/ equate the Sushumna directly with the Du Mai. hypofunction. When someone consistently produces Figure 2. The Heart and the Chakras Though this solution may be technically more accuproblems in this area, it is suggested that they are rate, it becomes constrained to associate Ida and Crown a Water CT. Pingala with somewhat obscure para- Du Mai conThe Void necting channels in which Qi ows in an ascendCASE REPORT 1 Forehead ing direction.6 Perhaps it is feasible to hold both Connection Root Chakra concepts in mind simultaneously since the theoThe patient was a 35-year-old man of a Tai-Yang retical validity of an interpretation is less imThroat Water constitution who injured himself falling Individuation portant than its practical applications. Specioff a ladder, straddling a 2-x-4 in the fall. He develcally, the opening and coupled points of either oped chronic perineal and erectile pain, and situHeart the Chong Mai (SP 4 [Gongsun], HP 6 [Neiguan]), Integration ational depression. or the Du Mai SI 3 [Houxi], BL 62 [Shenmo]) may Treatment included (among other things) a be used on occasion to help access the Kundalini. Power Tai-Yang Shao-Yin N+1 circuit, utilizing BL 62 Individuation The Chong-Mai Split (Shenmo) and KI 6 (Zhaohai) to incorporate the CV Since the chronically ill are often exhausted, and GV, plus needles in CV 1 and GV 1 when he Creative it would probably benet them to access this freely Connection seemed ready to accept them. During a session, the available energy source, which lies hidden beyond patient entered the void and started to shake the sight of the ego. However, one thing that can Root The Void uncontrollably, his pelvis moving in ways he bar access to the mingmen energy is a deep-rooted would not normally have permitted. After that parblock that arises from a collective fear and shame ticular session, his erectile pain dissipated. Figure 3. Symbol for the Heart Chakra of sexuality, a block that psychologists have called II. The Sexual Chakra Svadhisthana a love/sex split, but which might also be understood Sometimes called the navel center or Hara, the as a Chong-Mai split or block.11 The block arises when 2nd chakra is located between the pubic bone and the sexual energies are split off from the rest of the the navel. It is described as an orange lotus with 6 body-mind during the period of ego construction. petals and is traditionally associated with nutrition A Chong-Mai block generally manifests as 1 of and sexuality.9 Like the root chakra, this node 2 distinct containment/dissociation syndromes shares some common ground with the Chinese medthat, although easily identiable, often go unrecicine conceptions of both the Earth and Water eleognized in clinical practice.12 In the rst, when conments. However, perhaps the Earth element is the tainment is the dominant response, there is tenbetter match as sexuality, creativity, and nutrision and Qi congestion in the pelvic area with detion are so central to all levels of the body-mindciency above; in the second, there is Qi congestion spirit. Furthermore, svadhisthana is also clearly in the upper chest and head, with energy deciency concerned with interpersonal connection, which in the pelvis. In the latter case, there is often a palis very much an Earth theme. pable temperature differential between upper and The Ming Men and Kundalini lower Jiaos, with hot above and cold below. Chinese medicine calls the area below the CASE REPORT 2 umbilicus the dantian and considers it to be a storehouse of energy. Points with names such as Sexual Chakra CV 6 (Qihai) and GV 4 (Mingmen) are supercial A 45-year-old woman presented with migraine reections of the actual mingmen, which is an internal energy generaheadaches that she managed in the usual way with prodromal tryptans tor located midway between the 2 kidneys. In Chinese medicine theand the occasional meperidine rescue. She suspected that there might ory, energy generated from the mingmen passes down to CV 1 to supbe a deeper meaning to her headaches after attending a womans ply the extraordinary meridians before being distributed to the rest of workshop in which issues of childhood abuse were discussed. the body via the Triple Heater. Examination revealed a hot-above/ cold-below scenario with the temIn the Ayurvedic tradition, Kundalini energy is the basic energy or perature differential occurring somewhere in mid-abdomen. After creative force and is said to lie dormant at the base of the spine until some preparation and counseling, the patient expressed a wish to reclaim mobilized through special meditation and breathing techniques.10 The her disowned pelvic energy through an experiential exploration. classic image is of 2 sleeping serpents, coiled around the base of the Acupuncture was initiated with opening and coupled points of the spine, near the coccyx. When the serpents are awakened, energy beChong/Ren/Du Mai and local points in the lower abdomen and low
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back such as CV 4-6, ST 28-30, GV 4, and BL 23-26, and she was encouraged to physically move the pelvis. In time, as she learned to pull the diverted excess upper Jiao energy down to the pelvis, her headaches diminished and eventually disappeared. III. The Solar-Plexus (Power) Chakra Manipura Although some sources connect manipura with the mingmen and locate it at the level of the navel, others describe it as being the solar plexus or power chakra, located between the navel and the xiphisternum at CV 12 (Zhongwan), the Mu point of the Stomach, or on the back at GV 6 (Jizhong) and GV 8 (Jinsuo). It is described as a yellow or gold lotus with 10 petals and is traditionally concerned with power, control, recognition, and status.13 The chakra is activated when there is a need to set boundaries or otherwise make a statement of personal power. Self, Anger, Expression, Power The desire to connect and harmonize with others, arising from the 2nd chakra energies, can produce challenging situations when external demands become unreasonable, excessive, or manipulative. The conicted feelings will often engender a sense of pulling or tugging in the solar-plexus area, as if the area were tethered to a cord. In esoteric literature, these energetic tetherings have been called Aka cords.14 From a Five-Element perspective, such situations generally call for either: (1) boundary setting (Wood), mediated by the solar-plexus chakra, or (2) letting go and moving on (Metal), which is perhaps more the purview of the throat chakra. Either (or both) of these may be unavailable to those who have not brought such energies to consciousness. Instead, many people give the perception of equanimity by containing their resentment, which may lead to the syndrome of Wood invading Earth and manifest as gastritis, reux, food sensitivities, or peptic ulcer. In another scenario, Wood energies can get pushed down into the lower Jiao where they intermingle with and contaminate the contained/dissociated sexual energies, leading to a situation in which sexual and Wood energies are mixed and compartmentalized outside of rational consciousness. The story of Dr. Jekyll and Mr. Hyde illustrates this dynamic.15 IV. The Heart Chakra Anahata The Heart chakra, or anahata, is anatomically and energetically the center of the body-mind.16 Located in the middle of the chest at CV 17 (Danzhong) and on the back at GV 11 (Shendao), it is traditionally described as a green, orange, crimson, or gold lotus with 12 petals. The essential feature of the Heart energy is its capacity to acknowledge and be present with what is.17 Chinese medicine conceives Heart (Heart Yang) and Mind (Heart Yin) to be a Yin/Yang pair, and fuses them together as Heart-Mind or Xin.18 By separating Heart and Mind and relying solely on the intellect, many people have inadvertently forgotten the importance of the Heart center, which manifests as presence and compassion rather than planning and strategy. An open Heart permits both physician and patient to release the habitual compulsion to x or change things. This has its therapeutic advantages. For example, when patients become present, they may stop an often self-destructive quest to eradicate symptoms and instead become curious about them. Moreover, physicians soon discover that the phenomenon of presence forms the basis of the art of medicine. Though it may be interpreted supercially as inaction, compassionate presence can occasionally facilitate dramatic energy shifts that cannot be explained with the standard cause and effect model. How is it possible, one might ask, for symptoms to disappear when nothing is done? The idea is not reasonable. Yet such experiences happen and when

they do, they can quickly transform the patient's attitude and simultaneously, reframe a physician's view of health, illness, and medicine. The world is the same world but somehow, everything looks different. In Vedic philosophy, the root, heart, and forehead chakras are said to contain knots or granthis, representing aspects Brahma (the creator), Vishnu (the preserver), and Shiva (the destroyer), respectively. It is these knots that are pierced by rising Kundalini energy as the aspirant breaks the bonds of ignorance that tether him/her to duality. Located in the root with the sleeping serpents, the knot of Brahma may be loosened when the Kundalini rst becomes activated; while the knot of Vishnu, located in a trikona or inverted triangle in the Heart lotus, may be released through a transformational experience in which the ego is temporarily transcended. In this respect, the knot of Vishnu parallels Chinese medicine's Golden Gate.19 CASE REPORT 3 Heart Chakra A 43-year-old woman of Shao-Yin Fire presented with headaches and total body pain. She had been in 2 motor vehicle collisions. Associated symptoms included depression, insomnia, and asthma. There was a history of physical and emotional abuse in childhood, and she was taking numerous medications including oxycet, gabapentin, various antidepressants, and anxiolytics. Acupuncture treatment included, among other things, attention to the Shao-Yin Tai-Yang circuit, CV 17 (Danzhong), BL 15 (Shenshu), and GV 11 (Shendao). After several sessions in which nothing appeared to shift the pain, the patient attempted being totally present, reversing her customary habit of pain avoidance through continual movement and abreaction. Shortly after initiating this strategy, in the context of a triangular equilibration of the Shao-Yin, the patient entered a calm state and assumed a position resembling crucixion. After 10-15 minutes, she emerged pain-free and laughing. She later described the experience as nding a center in the middle of chaos. V. The Throat Chakra Vishuddsha Located just above the notch at the top of the sternum, the throat chakra is said to be a lotus of 16 petals, mauve, silver, or greenish-blue in color, and oval. It is the energy center related to expression and communication, inspiration, and detachment, which is why perhaps it has been associated with the Metal element in Chinese medicine.20 Letting go at the ego level may temporarily dissipate pent-up energy in the power center but eventually, a similar situation will arise, re-creating the habitual tension. On the other hand, letting go with an open Heart in a conscious and open expression of one's personal truth through a clear throat chakra not only prevents a build-up of tension but also, conrms agency and transcends the ego. There is a difference between venting angst and consciously speaking ones truth. The power to express is a double-edged sword that needs to be wielded with great care. If the Heart is open and Heart and Mind are one, then the energetic expression will generally be positive and life-supporting. On the other hand, if the Heart and Mind are separated, then the energetic expression may lack compassion. For physicians, this can be a critical issue, because scientic medicine and evidence-based protocols can be remarkably depressing if delivered with cool indifference. The art of medicine will always remain rooted in the dual skills of presence and compassionate communication. CASE REPORT 4 Throat Chakra A 35-year-old man of Jue-Yin Wood developed a stutter following a motor vehicle collision 2 years previously in which he had sustained mild whiplash. During 1 treatment session in which needles were placed

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in points such as KI 25 (Shencang), KI 27 (Shufu), CV 22 (Tiantu), and ST 9 (Renying), he felt a surge of heat up to his face. Immediately after the session, his stuttering disappeared as did his nearsightedness for which he had worn glasses for a number of years. VI. The Forehead Chakra Ajna The 6th chakra has been called the third eye, and is located between and just a little higher than the eyebrows in the center of the forehead. It has been described as a lotus divided in 2. One half is chiey rosecolored with yellow tinges, and the other half is primarily purplish-blue, each half having 48 petals.21 The 6th chakra is related to intuition, that inner vision that sees the truth directly, and has been associated with a whole brain function in which the frequency of brain waves range below the normal waking state (these frequencies are alpha [7-14 Hz], theta [4-7 Hz], and delta [0.5-4 Hz]; in contrast, normal waking consciousness generally produces frequencies in the beta range [14-35 Hz]). Such inner vision is functionally distinct from regular vision. Because the physical sense of sight is outer-directed, it is constrained to the duality of observer and observed. Intuition, on the other hand, is an inner-directed, unmediated knowing, in which knower and known are somehow connected or even united. In Chinese medicine, GV 24.5 (Yintang) is sometimes referred to as unnamed because the process of naming creates the very duality that the third eye transcends.22 Total brain coherence is a style of functioning that both transcends and includes the 3 states of waking, dreaming, and sleeping, and is known as turiya in the Ayurvedic tradition. As intuition develops, the individual becomes increasingly able to directly sense the root of things and situations without having to analyze or lter information through the reasoning faculties. The more intuition is trusted, the better it functions; and the better it functions, the more trust it deserves. Optimal functioning of the throat and Heart centers is crucial to such seeing, which is compassionate and nonjudgmental. To see truth completely is to see it lovingly, because there is no separation between observer and observed. Judgment separates observer and observed, creates the sense of duality, and leads to blockage or stagnation of Liver Qi. It is perhaps unfortunate that Western medicine diminishes the value of intuition in favor of left-brained rational thought, because the loss of intuition can be an impediment to a full understanding of the disease state. Without it, there is a tendency to restrict the search for cause to external factors such as bacteria or carcinogens, and to miss the opportunity offered by an illness to rediscover meaning and insight. CASE REPORT 5 Third Eye A 55-year-old First Nations man of a Tai-Yin Metal constitution presented with low back and knee pain. He did not talk much but when he did, he usually had something profound to say. During several sessions of acupuncture, in the context of a Tai-Yin/Yang-Ming circuit, GV 24.5 and local points around the knees, he retreated into the far reaches of the void, returning to describe visions and insights that seemed to go beyond his personal memory. In one, he journeyed into a hellish world where he saw the devastation of his people through smallpox. In another, he soared with ravens and eagles. In another, he saw his people being killed in a big battle which he felt was the battle of Wounded Knee. After this vision, during which he was deeply impressed by the synchronicity between image and symptoms, his knee pain disappeared. VII. The Crown Chakra Sahasrara (Atma) The 7th, or crown, chakra is the gate to the ultimate state of consciousness, union with the divine. Called sahasrara by yogis, it is

sometimes known as the lotus of a thousand petals and is predominantly violet, white, or gold.23 Chinese medicine refers to this point as Baihui (GV 20, hundred meetings), perhaps an echo of the yogic thousand petals. Located at or slightly above the vertex, the crown chakra connects the individual to absolute reality the Tao, or ultimate void, which both permeates and transcends duality. Though impossible to mentally understand, the Tao can perhaps be intuited by entering a kind of expanded awareness where knowing is experienced as being. In that vein, there is no doubt that miraculous things can happen in the treatment room when the physician is not actually doing anything in particular. Experience paradoxically teaches that the most effective practice is often nothing procedural. Being rather than doing, offering presence and refraining from interfering with whatever is happening, can be remarkably therapeutic. To quote the Tao Te Ching: Few things under heaven are as instructive as the lessons of Silence, Or as benecial as the fruits of Non-Ado.24 In addition, a few verses further on say: Learning consists of daily accumulating; The practice of Tao consists in daily diminishing. Keep diminishing and diminishing Until you reach the state of Non-Ado, Non-Ado, and yet nothing is left undone.24 It can be a great shock to discover the power of non-doing, but its utilization as a therapeutic maneuver is not without some justication. Since no one can ever understand all the factors involved in anothers illness, not acting is at least as sensible as acting and quite often leads to genuinely favorable outcomes. Furthermore, the principle of nonaction is at the core of the Chinese medicine philosophy and informs the state of wu-wei, or effortless mastery. In this state, the practitioner simply intends, without any particular effort, and sets a context for spirit to express itself through the acupuncture ritual. I have witnessed several crown chakra openings in which patients experienced an enormous ow of energy through the body, originating from the GV 20 area and pouring down through the body, followed by marked symptom amelioration. Some of these people had a prior diagnosis of a seizure disorder and had been taking antiepileptic medications, but chose to reduce the dose in preparation for a void exploration. In these cases, the patients own convictions that they had a pathology was the single most important factor preventing them from accessing the healing experience. Unfortunately, such pathologizing of the ow of transpersonal energies by Western medicine is very common.25 CASE REPORT 6 Crown Chakra A 46-year-old woman with systemic lupus erythematosus (SLE) had been dependent on a wheelchair for years because of exion contractures of her elbows, hips, and knees. One day, she entered the office springing up and down on her perfectly normal legs. She said she had attended a prayer meeting with thousands of people, during which she felt a bolt of energy enter through the top of her head. Immediately, she was able to get out of her chair and walk. CONCLUSIONS Though detailed instructions on acupuncture/chakra balancing are beyond the scope of this article, they can be found elsewhere.6 Nevertheless, even without an in-depth study of the subject, the ge-

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eral concept of chakras can easily be kept in mind during an acupuncture session, and appropriate points needled when symptoms suggest a particular chakra is involved; or, if someone is in a suitable psychospiritual state reecting the function of a particular node. Chakra points can be integrated into specic meridian circuits, used as focusing points in a resonating triangle balance, utilized to facilitate Qi movement in the CV-GV circuit, incorporated into Zang-Fu tonication protocols, or used simply as Ah Shi or trigger points. For example, someone looking for inspiration might benet from a needle in GV 20; someone lacking insight may benet from the use of Yintang; someone struggling with chaos might nd some centering with a needle at CV 17, or someone with boundary issues may benet from needles at CV 12 and GV 8. The astute physician can allow intuition to be the guide as to when and where to add a chakra point to an overall circuit design and can probably nd numerous ways to include the system in his/her practice. Beyond that, there may be a deeper necessity to explore the chakras. Specically, those who by luck or design have traversed the Golden Gate during acupuncture may have experienced the noumenon, in which they found themselves immersed in an energetically interconnected world with their ego temporarily in abeyance.26 Though initially exhilarating, the signicance of their experience might easily be forgotten or denied as the ego re-establishes its ascendancy as bodymind sovereign. Following such experiences, though physicians have an opportunity to help stabilize the transformational experience, they may paradoxically nd that their toolbox of protocols has become strangely inadequate. Since the conventional acupuncture model operates at ego level, continuous use of commonly accepted dualistic approaches may inadvertently serve to retard further progress by keeping patients mired in a small egoic notion of self. To get beyond this difficulty, alternate metaphors such as the chakra model can be very helpful. In my experience, it can be rewarding to work with people who have moved beyond the rst 3 chakras. Such people have long relinquished the typical narcissistic strategies that tend to plague initial therapeutic encounters such as naive outcome expectations, manipulative posturing, or a sense of therapeutic entitlement. Moreover, they tend to be genuinely grateful for the acupuncture experience and happy to take full personal responsibility for their use of professional time. In such a therapeutic relationship, the interaction often transforms into a patient-directed journey of exploration, while the practitioner's role becomes that of a witness who holds the space and grounds the experience in the silence of the void. ACKNOWLEDGMENTS The graphics were designed by Dr Greenwoods son, Richard Greenwood. REFERENCES
1. Muktananda S. Nothing Exists That Is Not Siva: Commentaries on the Siva S tra, u Vij anabhairava, Gurugt , and Other Sacred Texts. South Fallsburg, NY: SYDA n ia Foundation; 1997. 2. Seshadri H, Harihar S. The Science of Medicine: Where Modern Medicine Meets Spirituality. Chennai, India; 2002. 3. Greenwood MT. Accumulation/depletion syndrome: the energetic root of stress and burn-out. Medical Acupuncture. 2005;16(3):19-23. 4. Jarrett L. The loss and return of original nature: the Law of Husband/Wife. Am J Acupuncture. 1994;22(1):29-45. 5. Koven JC. Going Deeper: How to Make Sense of Your Life When Your Life Makes No Sense. Cathedral House, CA: Prism House Press; 2004.

6. Sankey M. Esoteric Acupuncture, Gateway to Expanded Healing. Inglewood, CA: Mountain Castle Publishing; 1999. 7. Martin SG. Root Chakra: also known as Security Center, Muladhara. http://www.chionline.com/chakra/Root.htm. Accessibility veried February 17, 2006. 8. Helms JM. Acupuncture Energetics: A Clinical Approach for Physicians. Berkeley, CA: Medical Acupuncture Publishers; 1997. 9. Martin SG. Navel Chakra: also known as sensation center, spleen Chakra, hara, svadhisthana. http://www.chionline.com/chakra/Orange.htm. Accessibility veried February 17, 2006. 10. Gopi K. Kundalini. Shambhala Publications; 1970. 11. Stein R. Incest and Human Love: The Betrayal of the Soul in Psychotherapy. Dallas, TX: Spring Publishers; 1984. 12. Greenwood MT. Psychosomatic compartmentalization: the root of Qi and Blood stagnation. Medical Acupuncture. 2001;13(1):23-28. 13. Martin SG. Solar Plexus Chakra: also known as Power Center, Manipura. http://www.chionline.com/chakra/Solar.htm. Accessibility veried February 17, 2006. 14. Sui CK. Pranic Healing. York Beach, MI: Samuel Weiser Inc; 1990. 15. Stevenson RL. Dr. Jekyll and Mr. Hyde. New York, NY: Penguin Books; 1987. 16. Martin SG. Heart Chakra: also known as Living Love Center, Anahata. http://www.chionline.com/chakra/Heart.htm. Accessibility veried February 17, 2006. 17. Jarrett LS. Chinese medicine and the betrayal of intimacy: the theory and treatment of abuse, incest, rape and divorce with acupuncture and herbs, part 1. Am J Acupuncture. 1995;23:35-51. 18. Greenwood MT. Acupuncture and the Heart-Mind Split. Medical Acupuncture. 2003;14(2):22-27. 19. Greenwood MT. Intention: needling without needles. Medical Acupuncture. 1999;11(1):17-23. 20. Martin SG. Throat Chakra: also known as Cornocupia Center, Vishuddha. http://www.chionline.com/chakra/Throat.htm. Accessibility verified February 17, 2006. 21. Martin SG. Brow Chakra: also known as Consciousness Awareness Center, third eye, Ajna. http://www.chionline.com/chakra/Brow.htm. Accessibility veried February 17, 2006. 22. Jarrett L. Constitutional type & the internal tradition of Chinese medicine, part 2. Am J Acupuncture. 1993;21(2):141-158. 23. Martin SG. Crown Chakra: also known as Cosmic Consciousness Center, "I am" Center, Sahasrara. http://www.chionline.com/chakra/Crown.htm. Accessibility veried February 17, 2006. 24. Tao TC. Shambhala Pocket Classics. Shambala Publishing; 1961. 25. Walsh R, Vaughan F. Paths Beyond Ego: The Transpersonal Vision. Los Angeles, CA: Jeremy P. Tarcher Inc; 1993. 26. Greenwood MT. Needle shock: adverse effect or transformational signal. Medical Acupuncture. 2004;16(1):14-17.

AUTHOR INFORMATION
Dr Michael Greenwood is Medical Director of the Victoria Pain Clinic, a residential facility in Victoria, British Columbia, Canada. Dr Greenwood specializes in chronic pain/chronic illness patients, developing techniques integrating the body, mind, and spirit. Michael T. Greenwood, MB (MD), BCHIR, FCFP, CAFCI, FAAMA, FRSA* Victoria Pain Clinic 103-284 Helmcken Rd Victoria, BC, Canada V9B 1T2 Phone: 250-727-6250 E-mail: michaeltgreenwood@shaw.ca *Correspondence and reprint requests

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