By Cathy Cassata
William Morris is the president of the AOMA Graduate School of Integrative Medicine in Austin, Texas, and practices at various clinics throughout Texas. He writes a column in Acupuncture Today, articles for American Acupuncturist, and is the author of Path of the Pulse, Chinese Medicine and Transformation, and Li Shi-zhen Pulse Studies, an Illustrated Guide. He focuses his studies on Chinese medicine (specifically Ding, Gu and Yang), and for eight years was mentored by Drs Shen and Hammer in the Menghe through the Ding family lineage of internal medicine. For five years, he also studied under Neiqiang Gu in the Gu family external medicine lineage. For thirty years, Morris has focused on pulse diagnosis, and his current work involves a synthesis of standard, family, and classical systems of pulse diagnosis. He gives seminars on pulse diagnosis, acupuncture, Chinese herbs, personal transformation and leadership. Morris spoke with the Fix about the role acupuncture and eastern medicine in general can play in aiding recovery and healing trauma.
Have you used acupuncture to treat substance and behavioral addictions?
Yes, both. Having said that though, I’m referencing using acupuncture within a healthcare context, where it’s not just the procedure of acupuncture being used, but rather the people who are working on these problems have a multi-disciplinary approach to the problem.
What would this multi-disciplinary approach involve?
There’s a new model that is happening in rehab facilities, which deals with physical, emotional and spiritual aspects of life and establishes a multi-disciplinary plan specific to each person. That plan may include meditation, yoga, acupuncture, body work, as well as various practitioners, such as a psychiatrist.
How does acupuncture fit into this approach?
Many treatment facilities will include acupuncture as part of their program for both detox and recovery. They may have a food regimen, exercise regimen, therapy, journaling time, down time and acupuncture may be scheduled into the plan a few times a week. Many times the addict will exit the program with familiarity of acupuncture and will also have set up acupuncture as part of their plan outside the treatment facility.
How does acupuncture work?
There are a number of theories about how acupuncture works. One involves modulating neurotransmitters. Most substances are operating in a lock and key fashion along the pathway of various neurotransmitters, so acupuncture may stimulate the body to create a substance which fits into the same spot on various cells, especially in the nervous system.
Another thought is that acupuncture stimulates the endocrine system, so there can be down modulating of adrenaline, and various stress hormones, resulting in relaxation. It also operates to either tighten or relax the vascular system, stimulating circulation and affecting circulation in varies areas of the body. In fact, stimulation of circulation is one of acupuncture’s primary functions. It also tends to reduce inflammation.
In the context of each of these mechanisms, acupuncture stimulates the body to correct itself. It gives the person resources to be able to process material that may be difficult. Particularly in addiction, often times there is suppression of a great deal of psychosocial material over the years. Part of the healing process is working through that material. Acupuncture creates a calm and equanimity with respect to working through that material within a cognitive therapeutic arena.
Does this apply to someone who is dependent on a substance because of a childhood trauma or something of that nature?
Yes. Let’s classify those types of events into the area of post-traumatic stress disorder (PTSD). Acupuncture is gaining a very large traction in the military for PTSD, and this is actually one of the areas that I specialize in. I published a paper looking at nitric oxide. In it I discuss studies showing that acupuncture and moxibustion, a traditional Chinese medicine technique that involves the burning of the herb mugwort, and placing it on points of the body, can promote healing. Both these tools would stimulate nitric oxide pathways between the hippocampus and the neocortex. The hippocampus is the place where long-term traumatic experiences are stored. This is entirely hypothetical, but I presume that this might be one of the pathways along which acupuncture is down-modulating, partly because acupuncture works at a trans-systemic level, in other words the immune, endocrine, vascular, and neuro systems are systems that we surmise are affected by acupuncture. These systems become disharmonic during the moment of a flashback or recall of a traumatic incident, so acupuncture communicates to all these systems, and in a way harmonizes them, resulting in down regulating intense responses.
Are there types of addiction that acupuncture seems to work more effectively with?
Acupuncture is stimulating the body’s own internal pharmacy. A drug can do what it does because the body already has a tool for having that experience to some degree. So acupuncture is rather robust in that respect, but I haven’t seen any studies that show its efficacy in terms of one addiction over another.
Can acupuncture help with relapse?
Stress and pain are both potential triggers for relapse, and acupuncture can help with both of these.
Why do you think people are hesitant to believe acupuncture works?
Evidence surrounding acupuncture’s effectiveness may be one reason. In studies, the notion of a placebo is extremely difficult to get when looking at a procedure like acupuncture. Most of the studies that I’ve seen that claim to have achieved placebo have used some sort of instrument for achieving it, and it’s questionable whether they’ve actually been able to establish that a real placebo was achieved.
For instance, in Europe there was a large study of over 3,000 patients on the use of acupuncture for lower back pain, which is a large problem and tied to addiction to pain medications. You really can’t separate the problem of pain and addiction, particularly, if one of the primary models of pain control is the use of chemicals. So if conventional care turns to a chemical, then the social system is almost encouraging the advent of addiction. This is a large piece of the problem. When results of this study were published here in the West, the news reported that there was no difference between acupuncture and the placebo. In reality, the issue may have been that they had a problem achieving placebo. In fact, I’m pretty certain that is most likely the case in many studies involving acupuncture. What this study did show was strong evidence that acupuncture reduced cost of care. This determination led the government to include acupuncture in its national healthcare packages.
What might change western society’s skepticism of acupuncture?
We are still in the process of discovering how to understand how acupuncture works probably because it’s part of a whole system of care that is conducted in the context of lifestyle recommendations, including herbs, nutrition, exercise, etcetera. As I mentioned earlier, there needs to be a whole host of concomitant healthcare strategies employed along with acupuncture so the real tools for understanding the degree to which acupuncture could be useful for a society is the more important question over does acupuncture work for a particular problem. It’s a larger systemic problem which requires a systemic view on the inquiry. Whole system forms of research or what are called “practice-based research models” that involves practitioners pooling their data, is what could likely demonstrate efficacy for acupuncture’s place in the western healthcare system in respect to which conditions it best treats, and may even uncover when it can be used for prevention of certain conditions.
The World Health Organization convened an expert panel to identify a host of conditions for which acupuncture was appropriate, such as allergies and various psychosocial problems associated with pain, and treatment of pain. That was one tool of evidence gathering, but we need more like it.
On a side note, there’s a good amount of conventional medicine that is practiced without evidence so the criticism should be placed on them as well.
Has there been any governmental support for acupuncture in the U.S.?
Acupuncturists have been providing services in the worker’s comp system in California for years since Jerry Brown’s first term in office. Recently, California has determined to include acupuncture in the Affordable Healthcare Act provisions. This means that every citizen in the state of California can now gain access to acupuncture. That’s a significant statement.
You mentioned moxibustion earlier. How do you incorporate healing plants into your practices?
Remember, humanity has relied on plants for healing purposes much longer than it's relied on isolated chemicals. It’s only been since the 1910s that the American public was convinced that a chemical and surgical basis of healthcare was the best. I think they both have their place for treatment of certain things, but there is a whole host of things being treated using those tools for which they are not appropriate.
Shock and trauma have a tendency to affect both the heart and circulation. When that takes place, fluid circulation (or lymph) in general can be affected as well as blood circulation. What happens is the vascular system can become contrasted, so we use herbs that have a mild diuretic and mildly dilate the vessels so the sweat pours open slightly, and the muscular system becomes more relaxed. We use plants that enhance the circulatory status and herbs that Chinese province says transform damp. In other words, they leech out fluids from places where they’re stagnant. Chinese sage is commonly used as well as kris ginseng, which is paradoxical because it has an action of both stopping bleeding and activating blood. Yarrow is a common western botanical that is used.
Can people use both conventional and non-conventional forms of treatment?
I think people should use the right tools for the job. Each of these approaches has a place. It might be a little myopic to use one or the other at the exclusion of possibly using the other, especially without having had explored it. That would not be congruent with the value of science. A neutral inquiry would be the scientific approach. Neutral questioning of the problems. Do herbs have a place here? Does acupuncture have a place here? Do pharmaceuticals or other conventions have a place here? As a society, we kind of have ourselves in a corner about beliefs about what good medical care is constructed of. It will take some undoing to get there.
If you’re interested in finding an acupuncturist in your area, Morris suggests visiting the website of the American Association of Acupuncture and Oriental Medicine.
Cathy Cassata is a regular contributor to The Fix. She last wrote about sugar addiction.