Published on 2026.08.13

When The Yellow Emperor 《黃帝內經》Meets Modern Psychology: Interactive Therapy for Depression

Introduction

The Huangdi Neijing 《黃帝內經》 (The Yellow Emperor's Inner Classic) categorizes (stagnation/depression) into two major categories:

The Stagnation of the Five Qi: Focuses on the "Five Movements and Six Qi" (Wu Yun Liu Qi), the natural environment, and the cyclical waxing and waning of the body's Qi dynamics.
The Stagnation of Emotions and Wills: Focuses on mental-spiritual states and the accumulation/stagnation of Qi within the Zang-Fu organs.

This article explores how mental-spiritual factors—specifically overthinking, anger, and fear—lead to the blockage of bodily Qi, resulting in the "Stagnation of Emotions and Wills." Using the interactive treatment of depression via Chinese Medicine Psychiatry and modern psychology as a case study, we examine how contemporary psychology can deepen and optimize TCM's "Four Examinations" (Inspection, Listening/Smelling, Inquiry, Pulse-taking and Palpation).

Tradition Chinese Medicine Psychiatry: How Emotions and Qi Dynamics Induce Depression

Description from the Yellow Emperor's Inner Classic in Traditional Chinese Medicine Psychiatry

1. Huangdi Neijing: Suwen – Ju Tong Lun 黃帝內經素問·舉痛論 (Treatise on How Pain Arises)

"Overthinking causes Qi to stagnate... When one overthinks, the mind becomes fixated and the spirit becomes localized. The upright Qi (Zheng Qi) halts and fails to circulate, hence Qi stagnates occur."

Interpretation: "Stagnated Qi" here refers to the stagnation of spiritual and emotional states. When a person overthinks or becomes obsessively fixated on something, their spiritual energy (Shen Qi) becomes overly concentrated on a single point. This causes the body’s vital energy (Zheng Qi) to stall, disrupting its smooth circulation. The Heart-Qi condenses, and the spirit becomes sluggish—this is the mechanism of "thinking causing Qi stagnation." This concept serves as the core pathology of Yu (stagnation) syndromes. Excessive mental activity consumes internal energy, causing Qi to stall in the Zang-Fu organs, chest, and abdomen. When the spiritual energy cannot flow freely, it manifests clinically as depression and anxiety.

Psychological Parallel: In modern psychology, this aligns with the “internal mental exhaustion” and “rumination” seen in patients with depression and anxiety. Rumination describes a psychological state where the brain repetitively and compulsively dwells on past negative experiences, mistakes, or worries without finding a solution. This mental loop acts as the pathological mechanism that triggers physical symptoms like body tightness.

2. Huangdi Neijing: Lingshu – Ben Shen 黃帝內經靈樞・本神 (The Root of Spirit)

"Those who suffer from deep worry and anxiety experience closed and obstructed Qi, which fails to flow and prevents its proper functions."

Interpretation: Excessive grief and worry cause the Qi mechanism to become depressed and stagnant, preventing normal circulation. This directly impairs the lung’s function of dispersing and descending Qi, which in turn hinders the flow of Qi and Blood throughout the entire body. When emotional stagnation leads to "closed Qi," the sluggish circulation easily impairs Heart and Spleen functions, manifesting as chest tightness, shortness of breath, loss of appetite, and chronic fatigue—ultimately culminating in depressive symptoms.

Psychological Parallel: In modern psychology, this reflects the energy state of patients with major depressive disorder (Depression), who exhibit low mood, irritability, frequent emotional outbursts, melancholy, loss of interest in activities, poor appetite, depleted Qi and Blood, and a severe lack of motivation.

3. Huangdi Neijing: Lingshu – Ben Shen 黃帝內經靈樞・本神 (The Root of Spirit)

a) " Those who are sorrowful will have their spirit weakened and apathetic; if they force themselves to labour, their vital energy is suddenly dissipated.

b) "When the Liver is affected by deep grief and sorrow, the Ethereal Soul (Hun) is injured... When the Spleen is burdened with unresolved worry, the Intellect (Yi) is injured..."

Interpretation:
a) People who are chronically sorrowful or anxious become listless and lethargic. If they then overexert themselves, their vital energy will be rapidly depleted. Worry injures the spleen and lungs. Sorrow causes stagnation and blockage of Qi, leading to slowed blood and Qi circulation and ultimately affecting overall bodily functions.
b) When a person suffers from profound grief, the Qi mechanism either stagnates or becomes severely depleted, causing disharmony in the Liver-Qi. Deprived of its anchor, the Ethereal Soul (Hun) wanders, leading to mental trance-like states, hallucinations, insomnia, and vivid, disturbing dreams. Similarly, excessive worry impairs the Spleen's transformative and transportive functions. Once the Spleen-Qi is damaged, the individual experiences sluggish thinking and poor concentration. Spleen-Qi deficiency also manifests physically as limb weakness and a total lack of physical drive (inability to lift the limbs).

Psychological Parallel: In modern psychology, this perfectly mirrors Bidirectional Mind-Body Feedback. The psychological state alters hormonal and neurological profiles, directly impacting respiration, appetite, blood circulation, and muscle tone. Conversely, these physical states feed back into the brain to regulate emotions, creating a continuous loop of mind-body interaction.

4. Huangdi Neijing: Suwen – Xuan Ming Wu Qi 黃帝內經素問·宣明五氣(The Manifestation of the Five Qi)

"The Five Zang organs store: The Heart stores the Spirit (Shen), the Lungs store the Corporeal Soul (Po), the Liver stores the Ethereal Soul (Hun), the Spleen stores the Intellect (Yi), and the Kidneys store the Will (Zhi)."

Interpretation: Traditional Chinese Medicine psychiatry provides an incredibly nuanced definition and evolutionary framework for these five distinct organ-mind dimensions.

Psychological Parallel: In modern psychology, the five internal viscera systems correspond directly to brain functions and psychological mechanisms recognized by neurology and cognitive psychology, seamlessly uniting the physiological and psychological realms:

Heart: Cognition, conscious awareness.
Lungs: Instinct, sensory perception.
Liver: Emotional processing, the subconscious.
Spleen: Sustained attention, memory.
Kidneys: Motivation, willpower.

5. Huangdi Neijing: Suwen – Yin Yang Ying Xiang Da Lun 黃帝內經素問· 陰陽應象大論 (The Great Treatise on the Corresponding Images of Yin and Yang)

"Anger injures the Liver, but grief conquers anger. Joy injures the Heart, but fear conquers joy. Overthinking injures the Spleen, but anger conquers overthinking. Worry injures the Lungs, but joy conquers worry. Fear injures the Kidneys, but overthinking conquers fear."

Interpretation: The Yellow Emperor's Inner Classic uses the principle of mutual restraint of the five elements to propose the "emotional mutual restraint therapy" (e.g., using grief to subdue anger, fear to temper excessive joy, anger to disrupt obsessive overthinking, joy to alleviate deep worry, and structured thinking to conquer paralyzing fear).

Psychological Parallel: In modern psychology’s emotional therapies share identical core idea:

Behavioural Activation (BA): Encouraging engagement in activities that provide a sense of achievement or pleasure to break the cycle of isolation and lack of motivation caused by depression (akin to "joy conquering worry").
Mindfulness-Based Cognitive Therapy (MBCT): Combining mindfulness with cognitive therapy to anchor attention in the present moment, allowing negative thoughts and bodily sensations to pass without worsening the emotional state.

Traditional Chinese Psychiatry and Western Psychology: Integrated Syndrome Differentiation and Clinical Practice for Depression

1. Liver-Qi Stagnation (肝氣郁結)

【Symptoms】 Gloomy mind, restlessness, susceptibility to signing, distending pain in chest and hypochondrium with unfixed painting – spot, eructation, fullness in stomach, abdominal distention, poor appetite, or vomiting, amenorrhea in women. The tongue coating is thin and greasy; the pulse is wiry.

【Key Diagnostic Points】 Gloomy mind, susceptibility to signing, distending pain in chest and hypochondrium, the pulse is wiry.

【Pathology Overview】 Emotional injury leads to a loss of the Liver's free-flowing function, causing Liver-Qi to become depressed and stagnant, disrupting overall Qi dynamics.

【Therapeutic Principle】 Soothe the Liver, regulate the circulation of Qi, and resolve stagnation.

【Recipe】 Chaihu Shugan San 柴胡疏肝散, Yueju Wan 越鞠丸.

Modern Psychological Theory: Emotional Freedom Technique (EFT) / Somatic Awareness

Modern Psychological Prescription: Apply Somatic Awareness techniques. Guide the patient to physically lean into the "fullness and distending pain" in their chest and ribs to discover the repressed emotions beneath it. Paired with breathwork, encourage the patient to safely vent the withheld resentment, tears, or anger trapped in their chest.

2. Melancholy Injuring the Spirit (懮郁傷神)

【Symptoms】 Mental trance-like states, restlessness, deep melancholy with a propensity to weep, frequent yawning and stretching. The tongue is pale with a thin white coating; the pulse is wiry and thin.

【Key Diagnostic Points】 Mental trance-like states, deep melancholy with frequent weeping, frequent yawning.

【Pathology Overview】 Unresolved melancholy consumes and injures Heart-Qi, secretly depleting the nutritive blood (Ying Xue) and leaving the Heart-Spirit deprived of nourishment.

【Therapeutic Principle】 Nourish the heart and calm the mind.

【Recipe】 Ganmai Dazao Tang 甘麥大棗湯 (Licorice, Wheat, and Jujube Decoction), Baihe Dihuang Tang 百合地黃湯 (Lily and Rehmannia Decoction) to nourish the heart, calm the mind, and moisten dryness.

Modern Psychological Theory: Humanistic Psychology & Safe Place Technique / Theory of Emotional Overcoming

Modern Psychological Prescription: Utilize the warm, unconditional presence of Humanistic psychology alongside "Safe Place" hypnotherapy techniques. When the patient is in a state of severe collapse or emotional numbness, establish a secure psychological containment space. At the opportune moment, gently guide them to recall minuscule, warm, and connected moments from their life to re-anchor the spirit.

3. Deficiency of Both Heart and Spleen (心脾兩虛)

【Symptoms】 Obsessive overthinking and worry, palpitations, easily frightened, insomnia, forgetfulness, sallow or dull complexion, dizziness, mental fatigue, poor appetite, muscular weakness. The tongue is pale; the pulse is thready and weak.

【Key Diagnostic Points】 Obsessive overthinking, palpitations, insomnia, sallow complexion, mental fatigue with poor appetite.

【Pathology Overview】 Mental overexertion and excessive worry impair the Spleen's transportive function. The Heart loses its nourishment, resulting in a dual deficiency of both Heart and Spleen.

【Therapeutic Principle】 Invigorate the Spleen, nourish the Heart, and augment/replenish Blood.

【Recipe】 Guipi Tang 歸脾湯 (supplement and nourish the Heart and Spleen, thereby generating Qi and Blood.)

Modern Psychological Theory: Cognitive Behavioural Therapy (CBT) / Breaking the Rumination Loop

Modern Psychological Prescription: Apply CBT cognitive restructuring to shatter the patient's negative cognitive loops (such as "I am useless, it is all my fault"). Through Behavioural Activation (BA), introduce simple, highly achievable tasks to break the vicious cycle of "unresolved overthinking." By shifting cognition, the brain's internal mental exhaustion is halted, which directly helps the Spleen and Stomach "resolve stagnation." When the brain stops twisting into knots, the upright Qi moves downward; the patient's appetite returns, generating a source for Qi and Blood, which provides a physical energy foundation for the depressed body.

Conclusion

The core philosophy of this integration can be summarized into three key insights:

A Shared Pathological Consensus on Mind-Body Unity: The "Stagnation of Emotions and Wills" in the Huangdi Neijing is fundamentally an obstruction and closure of the body's Qi dynamics. This aligns precisely with modern psychological models of depression, where rumination causes severe internal mental exhaustion, triggering a bidirectional mind-body feedback loop that manifests as neurological, hormonal, and somatic distress.
Neurological Mapping of the Five Zang Spirits: The spiritual dimensions outlined in the Neijing—the Shen, Hun, Yi, Zhi, and Po (神、魂、意、志、魄) stored across the five internal organs—can be mapped onto modern cognitive psychology and brain functions (cognition, emotion, the subconscious, memory, and willpower). This provides a scientific, objective depth for traditional TCM inquiry (Wen) and inspection (Wang), particularly through the lenses of micro-expressions and somatic awareness.
Interactive Mind-Body Harmonization: Clinical treatment should emphasize the ancient dictums: "First put the mind to sleep, then the eyes" and "The mediocre practitioner guards the form; the superior practitioner guards the spirit." Combining traditional Chinese herbal formulas (designed to soothe the Liver, nourish the Heart, and strengthen the Spleen) with Western psychological interventions (such as EFT “Emotionally Focused Therapy” emotional release, Safe Place hypnotherapy, and CBT cognitive restructuring) unties psychological knots while clearing visceral Qi blockages. This approach represents the highest ideal of contemporary integrated Chinese Medicine Psychiatry.

Dr. CHENG Lee Chuen

Education: PhD Guangzhou University of Chinese Medicine, PhD Shanghai University of Finance and Economics, Master of Traditional Chinese Medicine from the Chinese University of Hong Kong, Master of Business Administration from York University in Toronto Canada, Bachelor's degree from York University in Toronto Canada, and Higher Diploma in Tradition Chinese Medicine from the University of Hong Kong.
Professional qualification: Registered Chinese medicine practitioner in Hong Kong.
Work experience: Served as editor-in-chief of the Great China Chinese Medicine Website, lecturer of Chinese medicine courses in university educational institutions, lecturer of business administration courses in university, and registered Chinese medicine practitioner in clinics.
Research projects: Participated in university's market research on traditional Chinese medicine and health care products, and traditional Chinese medicine online model VR/AR teaching material development projects.
Publications/Books: Contents include articles such as “a literature discussion on Jingui Shenqi Pills〈金匱腎氣丸論述〉”, “research on consumer value and brand strategy of traditional Chinese medicine health products”, and “research on the impact of brand sensitivity of traditional Chinese medicine health products on consumers purchasing decisions” etc.

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