Letters

Chinese hypnosis can cause qigong induced mental disorders

BMJ 2000; 320 doi: https://doi.org/10.1136/bmj.320.7237.803/a (Published 18 March 2000) Cite this as: BMJ 2000;320:803

Chinese Qigong and the Qigong-Induced Mental Disorders

Dear Editor - After reading Lee's letter to editor on "Chinese
hypnosis can cause Qigong induced mental disorders,"[1] I felt a little
uneasy about the perspective expressed by him and the concerns that other
psychiatrists and physicians may raise. As a research scientist who
practices Qigong for years, I feel obligated to clarify some issues on
what is Qigong and what are the Qigong-induced mental disorders. As
Qigong becomes more and more popular around the world, these issues will
catch western physicians' attention sooner or later.

1. What is Qigong?
Qigong is one of the oldest traditional Chinese health care methods, and
is widely believed in China to have special healing and recovery power.
Traditional Chinese medicine (TCM) posits the existence of a subtle energy
(Qi), which circulates throughout all life being, and when strengthened or
balanced, can improve health and ward off or slow the progress of disease.
Traditionally Qigong therapy as an ancient TCM healing technique was
passed from generation to generation in a private and secret manner. Only
recently has Qigong become a public health practice in China and around
the world. Today it is reported that 70 million people practice Qigong in
China and undocumented numbers practice around the world to treat diseases
ranging from hypertension and arthritis to cancer and HIV [2-7].

All Qigong are not the same, we should not simply classify Qigong as
Chinese hypnosis or healing based on trance. Qigong is a general term for
a huge variety of forms of traditional exercises and therapies. They may
be roughly divided into two large categories (movement Qigong and static
meditation) and five major disciplines or traditions: the Confucian,
Buddhist, Taoist, medicine and martial arts. If I told you that the
popular Tai Chi Chuan was originated from secret Tai Chi Men Qigong, and
considered the movement form of Qigong, you may no longer want to classify
Qigong as hypnosis. Each of the five Qigong traditions has its own
purposes of training or practice, as well as different methods and various
forms to achieve those purposes. For example, the Buddhist Qigong tends
to emphasize the cultivation of virtue and enlightening wisdom, and it
considers the human body just a stinking bag holding the honorable spirit.
While martial-art Qigong emphasizes building up the body strength for
fighting and defense. Yet many martial-art Qigong practitioners have died
prematurely due to over exerting their body limits. Although various
forms of Qigong might all have some reported health benefits, not all
Qigong were designed for the purpose of health care or disease curing,
only medical Qigong takes treating illness or curing disease as its major
purpose.
Most Qigong practice involves some form of imagery meditation, deep
relaxation, or guided movement, and mind-body integration through
regulation and adjustment of body, breath and mind. Because of the deep
relaxation and "empty-mind" status during practice, it is reported that
Qigong practitioners usually have more efficient oxygen metabolism,
increased blood flow in the brain and a slower pulse rate [2, 8]. Good
Qigong practitioners in deep meditation and tranquility status seem beyond
their regular five senses, and unable to follow outside instructions like
the hypnotized subjects do. Many psycho-physiological changes reported by
Benson in relaxation responses can be found among Qigong practitioners.
However, Qigong practice seems more than just relaxation; practitioners
are said to develop an awareness of Qi sensations in their bodies and use
their mind or intention to guide the Qi. Some skillful Qigong
practitioners can reportedly direct or emit their Qi energy (external Qi)
for the purpose of healing others.

2. How Qigong Works for Health Purposes?
The mechanism of how Qigong works to achieve health benefits is still the
subject of further scientific exploration. However, according to TCM, the
available scientific literature and my own experience with Qigong, it
works to benefit the practitioners through the following three possible
paths.

(1) The relaxation and tranquility status related to Qigong practice
may reverse the chronic stress, build up the Qi (energy) or rapidly
increase the immune function [9]. This results in defeating certain health
problems related to immune malfunction or immune deficiency.

(2) The emphasis of "empty mind without desire" in Qigong practice
may help the practitioners release the suppressed emotion or straighten up
the twisted mental disturbance. Many chronic diseases of unknown origin
may be well related to this mental disturbance or emotional twist. During
some high-quality Qigong practice, practitioners tend to forget about the
disease, forget about the worrisome, forget about the environment and
forget about the self. They can behave as if they entered a place where
they can do whatever they want. Then we may observe sudden and frequent
emotional breakouts, such as crying, laughing, dancing, jumping and
turning around among the practitioners. Onlookers without Qigong
knowledge will definitely consider these movement mental disorders. After
this type of emotional breakout, the practitioners will feel some unusual
relief in their body and mind, and many discomforts may disappear
immediately. It was reported that a form of Qigong called "Hui Tong Dan
Tian Gong" (Intelligence through Dan Tian) in China was especially
effective in treating schizophrenia. Schizophrenia patients came to the
in-patient clinic and practiced this form of Qigong continuously in a
mental "disorder" way under close supervision. After one to two weeks of
practice, they could walk out of the clinic schizophrenia-free and return
to normal life.

(3) Motivated Qi (vital energy) strikes against sick locations.
According to TCM, good health is a result of a free flowing, well-balanced
Qi (energy) system, while sickness or the experience of pain is the result
of Qi blockage in certain areas or unbalanced energy in the body. Qi
imbalance occurs before any physical illness occurs. In order to stay
healthy and function well, people need to perform Qigong exercises to keep
the Qi flowing smoothly in the body so that each cell in the body gets a
constant supply of vital energy. Once the supply of Qi to the cells
become blocked, blood flow to that area will change, the cells or related
organs might start to malfunction, and disease or pain may occur [10, 11].
One possible mechanism of Qigong therapy for pain relief and symptom
reduction is through the relaxation of diseased or stressed tissues and
the increased strength of Qi flow to blocked areas. This leads to
increased blood flow to the afflicted area of the body. Increased blood
flow implies a more efficient delivery of oxygen, nutrients and pain-
killing substances, including the delivery of drugs as well as a more
efficient removal of metabolic waste products that could contribute to
pain and sickness [11].

3. Qigong-Induced Mental Disorders
Can Qigong practice really induce madness or mental disorders? The answer
is yes and no. The fact is that, through the history of Qigong practice,
there are indeed a few in the million of practitioners who derived no
benefits but did go on to manifest some form of distress or deviation.
From a psychiatric perspective, their symptoms have no difference from
mental disorders as defined in the DSM book. However, most cases of
Qigong-induce mental disorders or ultra deviation ("Zou huo ru mo")
occurred among those who practiced Qigong under merit-less Qigong
instructors or without any supervision at all. There were simply no
reports of mental disorders under the guidance of a knowledgeable Qigong
master. After a closer examination of those Qigong-induced mental
disorders, we find that many Qigong-induced deviations or "disorders" have
simply been a "false report".
According to the analysis of knowledgeable Qigong masters and my own
experience, there are three major types of so-called Qigong-induced
"mental disorders" that we may see in clinic: (1) Somatic responses to Qi
practice. Many mental disturbances or deviations are not a sign of
madness, but rather a normal reaction during the Qigong healing stage when
potential diseases appear and old diseases reemerge due to the
strengthened Qi striking against the blocked locations [12]. A subsequent
condition of intense pressure is experienced when the real Qi (vital
energy) in our body tries to push through the three major gateways on the
Du meridian. This accounts for the somatic stresses like swelling at the
cerebellum, loud echoes in the ear, swelling and pain in the neck,
shoulders, and arms. These are supposed to be good signs of Qigong
progress, rather than a mental disorder. (2) Out-of-control or
spontaneous movement and/or emotional expression (sudden laughing or
crying). This occurs sometimes among those involved practitioners whose
poor health conditions lead to this kind Qi-related movement but lack the
appropriate guidance or supervision. They are either not closing a
practice properly, or getting into a deep Qigong status which probably
needs continuous practice over the course in a few days. However, if the
inept practitioners stop practicing and search for medical help, the
situation may last much longer. Those without the guidance of a
knowledgeable Qigong instructor may be inclined to reach the false
conclusion that these disturbance were prelude to madness or deviation.
The unfortunate end result may be that the person who most requires more
Qigong practice would discontinue it, and seek unnecessary medical help
for no better reason than fear and worry [12]. (3) Illusive sight or
hearing. In the higher level of Qigong practice, about 1/3 of students or
practitioners may report strange and illusive images or hearing. Although
this phenomenon has not been well understood by scientists, it occurs
repeatedly among those involved practitioners, and usually accompanies
rapid progress in Qigong level. One of the common characteristics of
these illusive sights and hearings is that some of them might be truth or
become reality to the practitioners later, which make the practitioners
unable to tell the difference between a hallucination and an accurate
perception. This is called the "Zeng Wang Xiang Gong" stage where true
and false scenes conflict, an experience most advanced Qigong practitioner
experienced. It is normal from the perspective of Qigong practice, but
will definitely be considered a mental disorder by those who lack
knowledge of Qigong. This may be one of the reasons why Qigong was
traditionally passed down in a private and secret manner.

In addition, there are those who practice Qigong with less honorable
motives, namely, notoriety and wealth. Some of these people seek what may
be called a quick-fix, i.e. immediate recovery and instant success. Some
of them practiced Qigong for the purpose of reclaiming the
supernatural power or communicating with the spiritual world. Needless to
say, these wholly contradict the basic principles of Qigong practice, "a
life of simplicity and empty mind without desires". These ambitious and
wrong-headed practitioners wish to distinguish themselves by mastering
certain techniques such as "seeing with the third eye," levitation, moving
objects by intention, and ability to foresee the future. Those who seek
such power and misuse it will soon find themselves exhausted of all inborn
energy, deviated from normal Qi flow, and will themselves become "mentally
disturbed." All these unwholesome actions defy the laws of Nature and the
Way ("Dao"), should not be understood as a falsity of Qigong practice.

In short, most Qigong-induced mental disorders are the results of
practice without the proper knowledge of Qigong. In these cases,
physicians may consider a consultation with a knowledgeable Qigong master
first, and let the patient complete his normal course of Qigong practice
before taking any necessary medical treatment.

References:

1. Lee S. 2000. Chinese hypnosis can cause qigong induced mental
disorders. BMJ, 320:803 (18 March, 2000)

2. Feng, Lida, 1994. Modern Qigong Science. Beijing: Economic
Science Publisher.

3. Liu H, and Perry P, 1997. The Healing Art of Qi Gong: Ancient
Wisdom from a Modern Master. New York: Warner Books, Inc.

4. McGee, CT with Chow EPY, 1994. Miracle Healing from China:
Qigong. Coeur d'Alene.

5. Mayer M, 1999. "Qigong and hypertension: A critique of research."
The Journal of Alternative and Complementary Medicine. 5, 371-382.

6. Sancier KM. 1996. "Medical Applications of Qigong."
Alternative Therapies in Health and Medicine, 2(1): 40-45.

7. Sancier KM. 1999. Therapeutic benefits of Qigong exercises in
combination with drugs. Journal of Alternative and Complementary Medicine,
5, 383-389.

8. Jahnke R. 1990. "The physiological and energetic mechanisms
triggered in the human system by the self-applied health enhancement
methods: Qigong, Taiji, Yoga and mind/body health improvement practices."
In Proceedings of the 5th International Congress of Chinese Medicine and
the First International Congress of Qigong. June 22-23, 1990. CA:
University of California at Berkeley.

9. Ryu H, Jun CD, Lee BS, Choi BM, Kim HM, & Chung HT, 1995.
"Effect of Qigong training on proportions of T lymphocyte subsets in human
peripheral blood." American Journal of Chinese Medicine. 23(1): 27-36.

10. Lu N. 1999. Traditional Chinese Medicine: A Women's Guide to
Healing from Breast Cancer. New York, NY: Avon Books, Inc.

11. Yang, JM, 1996. Arthritis: The Chinese Way of Healing and
Prevention. Jamaica Plain, MA: YMAA Publication Center.

12. He, B. 1994. Breaking the Secret of Qigong, Guangzhou:
ZhongShan University Press.

Kevin Chen, Ph.D. MPH
Assistant Professor of Psychiatry
UMDNJ- New Jersey Medical School

Competing interests: No competing interests

29 November 2000
Kevin Chen
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