|Qigong Deviation Syndrome.
Incorrect performance of Qigong exercise can lead to some somatic or psychological disturbances, just like what appeared during the early phase of over-meditation reported by Otis in 1973.  Such syndrome manifested during or after the Qigong exercise may be called "Qigong deviation," which has become a diagnostic term now widely used in China. It has also been included in the Chinese Classification of Mental Disorders (1989.) 
The mental disturbances initiated by Qigong exercise has aroused wide interests and discussion now among Chinese psychiatrists and Qigong researchers.
The diagnosis of "Qigong deviation syndrome" showed the following criteria: 1) normal behavior before doing Qigong exercise; 2) psychological and physiological reactions appear during or after Qigong exercise; suggestion and autosuggestion may play an important role; 3) the manifestation of Qigong deviation syndrome does not meet the diagnostic criteria of schizophrenia, affective disorder and neuroses.
The clinically common symptom of Qigong deviation is the uncontrolled flow of "Qi" (energy) in the body. All of the cases has such complaints as "Qi moving and dashing within the body" or "Qi dashing and rushing into the head," often stagnating somewhere and leading to pain, with some strange perception in the lower abdominal area called "Dan Tian" (elixir field.) The incessant movement of the vital energy may give rise to an unusual malaise as well as various physical symptoms such as headache, insomnia, discomfort, abdominal distension and others. Owing to the exercisers' overemphasis upon the experience of "arrival of Qi," many interesting psychic phenomena may be derived from: Qi being "stolen" - for instance, an elderly woman was furious when the instructor removed her Qi to another exerciser. She gave that exerciser a box on the ear and asked him to return her Qi. "Induction" of Qi - once there were two exercisers (patients with chronic physical illness) who were in the same ward. One day, one of them gave a puff inadvertently to the other, the latter soon began to dance elegantly. After a little while he told the other mysteriously: "Oh, this is caused by the communication between my Qi and yours." The psychic problem may arise on account of the attitude of the exerciser to the Zi Fa Gong (spontaneous skill), which manifests itself as fast, strenuous and irregular movement with large motions. Some schools of Qigong (as in the crane-flying Qigong) emphasize that the earlier, the larger and the faster the spontaneous skill emerges, the better results will ensue, therefore the exercisers spare no efforts to seek for the spontaneous skill.  In most of the exercisers, sensation of Qi, as well as the spontaneous skill were caused by suggestion and autosuggestion and they are prone to develop psychic disorders.
The common symptoms in mental disturbance are anxiety, nervousness, depression, etc. Seriously ill patients cannot control their own behavior. Some patients are found to have hallucination or delusion, and some even have the impulse of committing suicide.
Qigong deviation syndrome is a mental disorder closely related to the cultural background, and also to superstition or witchcraft (Case 2.)
The mental and physical disturbances caused by Qigong deviation have the characteristics different from other psychotic disorders. Their causes are rather complicated. The author has done some tentative study on their clinical and causative factors.
Of the patients, 25 psychotic cases were assessed by Brief Psychiatric
Rating Scale (total mean score of BPRS: 44.89 ± 9.42), and 50 neurotic
cases were assessed by Hamilton Rating Scale (total mean score of HAMA
[Hamilton depression]: 16.82 ± 6.90; total mean score of HAMD [Hamilton
rating scale for depression]: 16.00 ± 8.30.) There are significant differences
between the Qigong deviation group and the control group (mean score of
HAMD: 2.58 ± 2.22, t = 11.04, P<0.001; mean score of HAMA: 1.94 ± 1.66,
t = 11.83, P<0.001.)
On January 15, 1985, the patient got upset because he was prevented by his family from doing Qigong exercise. He felt so hopeless that he attempted to commit suicide by bumping his head into a car. He was then sent to a hospital for psychiatric treatment. There were no abnormal findings in his physical and laboratory check-up. There was no history of psychosis in his family either. He was treated timely by ECT. Two days later, his father took him back home. Now he is followed up by a Qigong master and is so far in good health state.
Case 2: Mr. B is a 44-year-old married painter. He learned on his own the "He Xiang Zhuang" (crane-flying Qigong), another school of Qigong in February 1984, attempting to treat his ailment, the hypertrophy of cervical vertebra. He had no personal psychiatric history, neither his family. Several days after Qigong exercise, he was suddenly agitated with hyperthymia. He claimed that he knew everything in the world, "water is associated with the sea," when he talked about the sea, he would "think of the American continent."
Three days later, he was diagnosed as schizophrenia-like disorder and was treated in Shanghai Psychiatric Hospital. One month later he had remission.
Later he turned to learn the "Long Men Five Flow," another school of Qigong. On the third morning he suddenly began to cry and dance, still doing Qigong exercise in bed. He thought that his dead mother would be brought back to life whereas he would become a ghost. He said that he could see Buddha and God, and he believed in religion. He also smelt something unusual. He was again admitted to Shanghai Psychiatric Hospital.
Mental examination: the patient has emotional instability, with no delusion and hallucination, sometimes posing in a Qigong gesture and has intermittent attacks. EPG: extroversion. MMPI: schizophrenic character. He was given 100 mg CPZ im, bid. A week later, he recovered from his illness and now works as before.
Attention should be paid to the prevention and treatment of various mental and physical disturbances due to Qigong deviation.
In Chinese medicine, the qi, the mind, and the breath are all closely
related. In a sense, these are not three separate things but are aspects
of a single reality. Numerous Chinese medical classics, such as the Nei
Jing (Inner Classic) and Nan Jing (Classic of Difficulties), describe how
the qi moves through the body in co-ordination with the breath. It is the
lungs' respiration, which diffuses and scatters the ancestral or chest
qi to spread and extend to the rest of the body. In addition, consciousness
in Chinese medicine is referred to as the spirit brilliance, and the spirit
is nothing other than the accumulation of qi in the heart. According to
many Asian schools of meditation, the thoughts in the mind come and go
with the movement of the breath. Therefore, alterations in respiration
correspond to alterations in thinking and vice versa. Further, it is qi,
which moves the body in space. Hence, there is likewise a relationship
between the movement of the mind, the circulation of qi, and the movement
of the body.
The Symptoms of Qigong Disease
1. Qi stagnation & blood stasis pattern
2. Phlegm fire harassing above pattern
|3.Yin vacuity-fire of effulgence pattern
The main symptoms of this pattern of qigong disease are emotional depression, difficulty thinking, poor memory, mumbling and speaking to oneself, fright palpitations, generalized fear and dread, auditory and visual hallucinations, vexatious heat in the five hearts (meaning the heart and the centers of the hands and feet), a dry mouth and throat, insomnia, night sweats, a red tongue with scanty fur, and a fine, rapid or surging rapid pulse.
If one is already habitually kidney yin depleted and vacuous (as are many thin people, women, and the elderly), doing too much or erroneous qigong may cause excessive psycho-emotional tension. In addition, compulsively chasing ones thoughts or a desire to emit qi or possess other such supranormal qigong abilities may cause one to exhaust oneself in one's practice. This exhausts and consumes the essence and blood.
If the essence and blood become insufficient, then the sea of marrow will lack nourishment. This then leads to difficulty thinking, dull-wittedness, and decreased memory power. Essence and blood depletion and vacuity leads to heart spirit lack of nourishment. Hence there is emotional depression, mumbling and speaking to oneself, fright palpita-tions, fear and dread. Yin vacuity
leads to vacuity fire flaming upward. Therefore, one sees vexatious heat in the five hearts, a dry mouth and throat, insomnia, and night sweats. The red tongue with scanty fur and the fine, rapid, surging rapid pulse are signs of yin vacuity with internal heat.
What to do About Qigong Disease
BOB FLAWS is the single most prolific writer on Chinese medicine in
English. Author, translator, and editor of over 100 books and scores of
articles in both professional journals and general magazines, Bob regularly
teaches around the country and around the world. Some of his other credits
include being a founder, past president, and life-time Fellow of the Acupuncture
Association of Colorado, a Fellow and past Governor of the National Academy
of Acupuncture & Oriental medicine, past editor of the National Academy's
journal, a Fellow of the Register of Chinese Herbal Medicine (UK), a founder
of the Council of Oriental Medical Publishers, and the founder, publisher,
and editor in chief of Blue Poppy Press, Inc. Bob has been in private practice
in Boulder, CO since 1979 where he specializes in gynecology, pediatrics,
and complex internal diseases.
|From Hong Kong J Psychiatry 2000;10(3):12-14.
QIGONG PRACTICE IN CHINA
(MD, Director, Department of Social and Cross Culture Psychiatry, Shanghai XuHui Mental Health Center, Shanghai, China.)
Mental disturbance following meditation has been described in western culture (6) as well as in the Chinese traditional medicine literature. Such abnormal physical and psychological disorders are known as Qigong deviation syndrome. The first report occurred in China but has since been reported among Chinese living in other Asian countries and even in the USA. Since 1985, mental disorders associated with Qigong deviation syndrome have increasingly been reported in psychiatric journals and discussed in clinical practice.
Such abnormal psychological phenomena have aroused interest among medical circles and Qigong masters.
METHODOLOGY AND RESULTS
Of the 129 patients suffering from culture-bound syndromes associated with Qigong practice, there were 106 males and 23 females. Their ages ranged from 16 to 74 years with a mean age of 34.6 years. Among them, 100 patients practised Qigong by themselves, and only 23 under the tutorship of a Qigong master, while six practised in groups. According to the folk beliefs, the patients could be classified as having 'adverse flow in body' (62 patients), 'uncontrollable behaviour' (10), 'zou huo' or over-meditation (28), and 'spirit possession' (29).
Among the different psychiatric symptomatologies,
32% (41 patients) had sensory problems, 24% (31) had memory problems, 26% (34) had attention difficulties, 90% (116) had mood symptoms, 18% (23) had thought disorders, 37% (48) had behavioural problems and 3% (4) had disordered consciousness.
The authors conducted various psychiatric assessments for 'possessed'
patients and found a mean Brief Psychiatric Rating Scale (BPRS) score of
44.8 ± 9.42, signifying quite serious psychopathology. They also evaluated
50 patients with mood symptoms and found anxiety and depression levels
(mean Hamilton Depression Scale score of 16.8 ± 6.9 and Hamilton Anxiety
Scale score of 16.0 ± 8.3, respectively) that were statistically higher
than those of healthy controls.
|DISCUSSION OF QIGONG-INDUCED PSYCHIATRIC DISORDERS BELIEFS IN CAUSATION
According to conventional beliefs, Qigong-induced psychiatric disorders could easily occur under the following conditions:
It is quite interesting that most patients have relatively acute attacks of short duration. After the attacks, they feel relatively exhausted and many have partial or complete amnesia about their behaviour. The most common syndrome is an acute psychotic reaction, quite a significant proportion of which are similar to that of schizophreniform disorder.
These psychotic syndromes usually occur a couple of days after Qigong practice. Other presentations could mimic affective disorders, dissociative (hysteria), and other neurotic disorders. For those diagnosed with schizophreniform disorders, the clinical symptoms include delusions, hallucinations, and disorganised speech. Quite often, there is accompanying over-talkativeness and elation of mood. There can also be abnormal behaviour, especially that of 'posturing' using the various exercise postures of the Qigong practice. The first rank symptoms of schizophrenia described by Schneider such as thought control or alienation may be apparent, but are not always present.(11)
A number of patients could be described as suffering from an affective disorder, with either depressive or manic episodes. For those diagnosed as having various forms of neurotic disorders, the clinical manifestations can be divided into physical and psychological forms. Nearly all patients have a special complaint of something like "the Qi moving within the body, and dashing or rushing into the head". Often, such `qi' becomes stagnated somewhere, leading to headache, dizziness, or strange perceptions in the lower abdomen (called the `Dan-Tian point'). Psychological symptoms include hypochondriasis, obsessive thoughts or images, phobia, suicidal ideas, and feelings of sadness, anxiety, and worries about being out of control. For those who manifest with the dissociative state (previously labelled the 'hysteric syndrome'), there are features of disturbed consciousness, disorientation of time, place, and person, and visual and auditory hallucinations. Such features usually occur after Qigong practice for 2 weeks or a month.
DIAGNOSIS OF A CULTURE-BOUND SYNDROME