Back to Basics: Qi Cultivation by Jennifer M. Moffitt, MS, L.Ac., Dip. OM Jennifer Moffit is a Licensed Acupuncturist with a Masters of Science in Traditional Oriental Medicine. She received a Bachelor's of Science in Environmental Toxicology at UC Davis, teaches Oriental Medicine to medical students at UCSD, and practices in San Diego at the West Coast Center for Integrative Medicine.

As you already know, qi is the body's vital energy - sort of like gasoline to a car - although it can seem more elusive in concept. I have tried to show that there is a lot to maintaining our engine - the physical body. At every level, if something is neglected there is potential for us to 'spring a leak.'

I find it helpful to think of healing and health in terms of a pie chart - we can even give it a title. In our "Pie Chart of Self Care" every aspect must be present in order for the chart to be complete. Let's consider the ideal first…

A Perfect World (sigh):

In our idealized view, as you can see, all the elements of self care are pretty evenly represented, with a category I like to refer to as "Sheer Luck" being the smallest of all the values at around 5 %. By 'luck' I mean that margin of error (or grace for the more optimistically inclined), by which we can use and abuse this balance and avoid health pitfalls or injury. You know - all those near misses on the freeway, too many Frappacino's in the summer, not enough veggies - they draw from the 'luck' category.

Unfortunately, the 'Pie Chart of Self-Care' in the folks I see clinically usually looks more like this:

Hmmm, not enough of several elements, and far too much reliance on 'luck.'

For the patients who come in with a chronic illness or acute injury, often it seems like luck has run out. And then we have an added category which I like to call "Meds' which has with it pros and cons as well.

The reason I bring out visual aides this month is to drive home the point that all the elements of self-care are important. Far too frequently we rely on one or another and hope it is enough. Then we go to the physician (of whatever modality) and expect them to fix the deficits in our self-care, preferably as quickly as possible.

For chronic conditions which have been around a long time, whether pain or internal medicine - many times there are been aspects of self-care which may have been neglected for months or years. I find this is true even with an injury that is sudden onset - an accident or a pulled muscle that is very painful and which refuses to heal. How entrenched an injury becomes is often a reflection of the care and maintenance that was given to the body prior to the onset of the problem. So even if you never had a chronic backache before, if it suddenly shows up over night, and you have not been including bodywork, nutrition, exercise, play, etc., realize that you were primed for a condition to develop.

Realize there is no blame here - these are aspects that have been ignored and minimized by western medicine for far too long. I may be dating myself here by mentioning that the sayings my grandmother used to quote (while sneaking last night's peas into my pancakes) were true more often than not, I just had to go through 10 years of school to realize it. The good news is that the word is out - now you know too and you can use all these tools to help restore and maintain your health.

Now there are a few sections of self-care that we have not covered yet - qi cultivation, play/pray, and exercise. We will cover these as a unit because they have a common theme. In future columns we will cover more about the TCM approach to the mind and emotions and how they affect the physical organs. I want to make a pitch to include some of the following activities in your self-care routine and briefly explain why.

Qi Cultivation (Tai Qi, qi gong, yoga, martial arts), Play/Pray, Exercise

I include the all of the above as Qi cultivation because in different ways they all help balance the cellular effects from certain physical and emotional states, and to help maintain the patency or 'free-flowing' nature of qi. Some of you who read my article on bodywork now understand that the nature of qi is like a river, and it needs to flow freely and evenly. Chronic pain and disease are signs that the qi has gotten diminished or stuck in some way. This category includes ways to help ensure that qi moves freely and smoothly, and also helps bring a level of self-awareness into your body to help prevent recurrences in the future.

Qi cultivation or Qi gong is the 4th of the four pillars of traditional Chinese medicine: Acupuncture, Massage, Herbal Medicines and Qigong. Broken into its component parts: Qi and Gong: Qi = vitality, energy, life force, Gong = practice, cultivate, or mastery. 3 Roughly speaking, it is the practice of cultivating or nourishing one's life force energy. In layman's terms, these are practices by which you can not only fill up your gas tank, but also keep the motor more finely tuned.
The more classical oriental traditions include meditation exercises of Qi gong, and tai ji. But these are rooted in a very different culture than ours, and many of my patients have not had a heart connection with the practices. I like to include general exercise, play/prayer, yoga, pilates within this category. What types of qi cultivation you choose depend on personality and taste, and I don't find one to be more beneficial than the other. It should be something in which you find immediate gratification (or you won't continue doing it).

I have experimented with almost everything - sadly I lack the temperament to do tai ji - gave it my best shot for over a year and do not have the patience for it. But I had immediate luck when I started doing yoga for my back, so to each his own. My own reasons for beginning a practice of qi cultivation were very prosaic and not rooted in anything nobler than my finances - I was a poor grad student and could not afford to go see the chiropractor much. I had to find something to help with the back pain that I could do on my own. After taking a few workshops, I learned a series of poses that were very helpful for my condition, which I continue to this day.

In general I find there is a need for something with movement and stretching (frees up the qi in the large muscle groups and maintains flexibility and strength) and something that allows for quiet time and contemplation (relieves stress and allows the body to mentally and physically recharge). Sometime they can be combined like long walks on the beach with the dog, so again, search out ones that are pleasing.

In addition to the physical benefits of clearing out stress, improving flexibility, freeing up stuck qi from the large muscle groups, the process of qi cultivation for me personally has brought with it a greater level of awareness of how I hold myself during the day, where my qi gets stuck, how my emotions affect me physically. This is very liberating because I am much less at the mercy of them - I am more aware that when I haven't taken the time to stretch or have quiet time for inner contemplation, I am a little too tightly wrapped, both mentally and physically. And I have learned over time, that when this gets really out of balance, then I get grumpy, my back goes out, and the cycle begins again. The great news is that I have the practices to go back to, and within a fairly short period of time, the qi is flowing, and my body and mind are in better shape. This is ultimately the essence of qi gong within any tradition - the art of mindfulness - to discover more of yourself and how you move in relation to yourself and the rest of the planet, and how to make that more peaceful and harmonious.

All Work and No Play…

I also find that 'play' is one of the most important aspects of self-care, and one that seems to get left behind after childhood. Dogs and kids remember this. Play can be anything, but it should be something that genuinely is joyful, makes you glad to be alive, and renews the heart. Dinner parties with friends, tennis, golf, singing, salsa dancing, church choir. It doesn't matter what.

Let's be honest, martyrs are boring - remembering to play makes us more enjoyable to be around, and it provides a reserve of good feelings so that on bad days I am less likely to go home and kick the dog or yell at my spouse. It gives us a cushion - which again is partly biochemical! If we go back to the idea of cellular chemistry, play has a powerful affect chemically on the body in terms of the pleasure receptors in the brain, and stimulates the immune system. From the TCM perspective, it helps to stimulate the heart energetic (joy), and relieves mental and physical stagnation. Seriousness of mind leads to seriousness (or stuck- ness) of the body, and we now know what happens now when the qi gets stuck.

In the oriental classic, The Great Dao 2 (a great read by the way), great attention is given to qi cultivation and self- care - meaning right diet, right action, right thought, bodywork like tui na, etc. Acupuncture was considered crude and invasive - it was only used when the other aspects had been neglected. For the practitioner who was skilled in therapeutic massage and offering wise counsel in terms of diet, exercise, and mindfulness, there was no need to resort to something as crude as needles…. While I am not yet ready to give up my weekly acupuncture visits, this brought me to a renewed respect for all the elements of self-care, including qi cultivation. Truth be told, there are not enough hours in the day for me to do everything I need to maintain myself so that I don't need to rely on bodywork to help balance the equation.

I would rather go horseback riding….

Contact me directly at jmoffitt@acunut.com.

1. http://www.what-is-cancer.com/index.html
2. The Great Dao Doctrine was founded by Liu Deren, who declared that an old man had taught him the mysterious Dao in the second Huangtong year (AD 1142) of the Jin dynasty (1115-1234), leading to the birth of the Great Dao Doctrine. (http://www.eng.taoism.org.hk/general-daoism/major-daoist-sects/pg1-3-18.asp)
3. http://www.feeltheqi.com/articles/rc-qigong.htm