Zou huo ru mo (medicine)

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Zou huo ru mo or "qigong deviation", is a Chinese term traditionally used to indicate that something has gone wrong in martial arts training, applied to describe a physiological or psychological disorder believed to result during or after qigong practice, believed by the qigong community to result from "improper practice" of qigong and other self-cultivation techniques, and highlighted in the social and political context of mass popularization of qigong in China.


The term zou huo ru mo means "Walking fire entering demon".[citation needed] In recent times this syndrome has been known as qi gong pian cha "qigong deviation".[citation needed] The term has traditionally been applied to indicate that something has gone wrong in one's martial arts training, interpreted as "imbalance of qi (life energy)". In more recent history, the term has been applied to refer to undesirable somatic or psychological effects experienced during or after the practice of the broad range of Chinese self-cultivation exercises known as qigong.[1][2] Most cases do not last for an extended period of time, and are never brought to medical attention.[3] While qigong may act as a stressor in vulnerable individuals, relations between qigong and disorders are manifold, and causal relationships have not been demonstrated.[4] Similar syndromes have been observed in other forms of self-cultivation practices such as yoga (Kundalini syndrome),[5] meditation,[6] and hypnosis.[7]


Symptoms are often identified as being in one of three categories:

  1. panic, discomfort, and uncontrolled spontaneous movement;
  2. sensory problems, such as visual or auditory hallucination; and
  3. irrational beliefs.[1]

Somatic symptoms can include sensations and pain in head, chest and back, abdomen, limbs, or whole body; whereas, mental and emotional symptoms can include neurasthenia, affective disorder, self-consciousness, hallucination, and paranoia.[8]:165–167


While the Chinese Society of Psychiatry prefers the term "qigong deviation", the American Psychiatric Association uses psychosis terminology.[9] Some physicians believe that this disease can be categorized as a culture-bound syndrome, but this point is debated.[2]

Chinese psychiatry[edit]

In the second edition of the Chinese Classification of Mental Disorders (CCMD-2) published by the Chinese Society of Psychiatry[10] the diagnosis of “Qigong Deviation Syndrome” is based upon the following criteria:[11]

  • The subject being demonstrably normal before doing qigong exercises
  • Psychological and physiological reactions appearing during or after qigong exercises (suggestion and autosuggestion may play an important role in these reactions)
  • Complaints of abnormal sensations during or after qigong exercises
  • Diagnostic criteria do not meet other mental disorders such as schizophrenia, affective disorder, and neurosis.

Occidental Psychiatry[edit]

In the West, there was no equivalent experience until the adoption of qigong practices by the public. When the Western medical community encountered abnormal conditions presenting in patients practicing qigong, they used the term "Qi-gong psychotic reaction" and classified the disorder as a culture-bound syndrome in the 4th edition of the Diagnostic and Statistical Manual (DSM-IV) of the American Psychiatric Association. It is described as

[a] term describing an acute, time-limited episode characterized by disassociative, paranoid, or other psychotic or non-psychotic symptoms that may occur after participation in the Chinese folk health-enhancing practice of qigong. Especially vulnerable are individuals who become overly involved in the practice.[12][13][14][15]

In order to diagnose this disease in the West, practitioners determine the cultural formation of the patient; this includes their cultural reference group and how that culture might explain their illness.[16]

The DSM-IV classification has been criticized by other Western psychiatrists on the grounds that

[i]t is not clear how the architects of the DSM-IV can logically defend labeling a syndrome as aberrant in the context of a diagnostic system while simultaneously placing that syndrome outside of conventional Western nosologic categories that serve as basis for determining whether a syndrome is or is not aberrant and therefore a disorder.[17]

Medical Causes[edit]

The appearance of symptoms during or after qigong practice has been explained in various ways by the psychiatric community, in severe cases as an indication of latent psychosis. The Chinese medical literature includes a wider variety of symptoms associated with qigong deviation; the non-psychotic symptoms correspond to conversion disorder and histrionic personality disorder in Western classifications.[18]

Latent psychosis[edit]

In cases of psychosis, a Western psychiatric belief is that qigong could be a precipitating stressor of a latent psychotic disorder to which the patient is predisposed, rather than erroneous qigong practice;[18] a type of reactive psychosis or the precipitation of an underlying mental illness, such as schizophrenia, bipolar disorder, or posttraumatic stress disorder.[19]

Qigong community perspective[edit]

Within the qigong community, Zou huo ru mo is believed to be caused by improper practice:[20]

  • Inexperienced or unqualified instructor
  • Incorrect instructions
  • Impatience
  • Becoming frightened, irritated, confused, or suspicious during the course of qigong practice
  • Inappropriate focus, interpreted as "inappropriate channeling of qi (life energy)i"

Within the qigong community, there are specific treatments believed to be effective for addressing different forms of Zou huo ru mo.[20] In particular, depending upon somatic versus psychological symptoms, and whether the condition is considered temporary or an intrinsic mental disorder, self-correction treatments can involve relaxation, walking, self-vibrating, self-patting, and self-massage; whereas clinical treatments can involve psychological counseling, expert guidance of practice, acupuncture, massage, "external qi" treatments, and symptomatic correction[8]:164–173

Social and political context[edit]

Qigong deviation was highlighted in the context of political controversy during the 1990s, when the Chinese government became concerned about loss of state control due to widespread popularity of qigong, mass practice, and rise to power of charismatic qigong "grandmasters".[1][21]


  1. ^ a b c Chen, Nancy N. (2003). "Chapter 4. Qiqong Deviation or Psychosis". Breathing spaces: qigong, psychiatry, and healing in China. Columbia University Press. pp. 77–107. ISBN 0-231-12804-5. 
  2. ^ a b Shan, HH (2000). "Culture-bound psychiatric disorders associated with qigong practice in China" (PDF). Hong Kong J Psychiatry: 10–14. 
  3. ^ Lee, Sing (December 1996). "Cultures in psychiatric nosology: the CCMD-2-R and international classification of mental disorders". Cult Medicine Psychiatry 20 (4): 421–472. doi:10.1007/bf00117087. Retrieved 2013-05-14. 
  4. ^ Ng BY. 1998. Qigong-induced mental disorders: a review. Australian & New Zealand Journal of Psychiatry 33(2):197-206.
  5. ^ Upadhyaya, Pt.Rajnikant (2006). Awake Kundalini. Lotus Press. p. 26. ISBN 81-8382-039-5. 
  6. ^ Nelson, James M. (2009). Psychology, Religion, and Spirituality. Springer. p. 470. ISBN 0-387-87572-7. 
  7. ^ Gibson, Hamilton Bertie (1991). Hypnosis in therapy. Psychology Press. ISBN 0-86377-155-6. 
  8. ^ a b Liu, Tian Jun; Qiang, Xiao Mei, eds. (2013). Chinese Medical Qigong, Third Edition. Singing Dragon. ISBN 978-1848190962. 
  9. ^ Liu, Lydia He (1999). Tokens of exchange: the problem of translation in global circulations. Durham [N.C.]: Duke University Press. p. 315. ISBN 978-0-8223-2424-9. 
  10. ^ The Chinese Society of Psychiatry (1989). "66. Qigong deviation syndrome". Chinese Classification and diagnostic criteria of mental disorders (CCMD-2) (Beijing). CCMD-2. 
  11. ^ Rights Watch, Human (2002). Dangerous minds: political psychiatry in China today and its origins in the Mao era. New York, N.Y.: Human Rights Watch. ISBN 978-1-56432-278-4. 
  12. ^ DSM-IV-TR, American Psychiatric Association, p. 902
  13. ^ Schatzberg, Alan F.; Hales, Robert E. (2008). American Psychiatric Publishing Textbook of Psychiatry. American Psychiatric Publishing, Inc. p. 1551. ISBN 978-1-58562-257-3. 
  14. ^ Vuong, Ngan Kim (2006). "Cultural Bound Syndromes: Qigong Psychotic Reaction". In Jackson, Yo. Encyclopedia of Multicultural Psychology. Sage Publications. pp. 142–143. ISBN 978-1-4129-0948-8. 
  15. ^ Sandhu, Daya Singh (1999). Asian and Pacific Islander Americans : issues and concerns for counseling and psychotherap. Commack, N.Y.: Nova Science Publishers. p. 231. ISBN 978-1-56072-663-0. 
  16. ^ Hwang, Wei-Chin (1 December 2007). "Qi-gong Psychotic Reaction in a Chinese American Woman". Culture, Medicine and Psychiatry 31 (4): 547–560. doi:10.1007/s11013-007-9065-z. Retrieved 2013-05-14. 
  17. ^ Robinson, Bruce H. (2007). Biomedicine: A Textbook for Practitioners of Acupuncture & Oriental Medicine. Blue Poppy Press. p. 434. ISBN 978-1-891845-38-3. 
  18. ^ a b Robinson, Bruce H. (2007). Biomedicine: A Textbook for Practitioners of Acupuncture & Oriental Medicine. Blue Poppy Press. p. 435. ISBN 978-1-891845-38-3. 
  19. ^ Sing, Lee, & Kleinman, Arthur (2002). "Psychiatry in its Political and Professional Contexts: A Response to Robin Munro" (PDF). J Am Acad Psychiatry Law,. 30:120–5: 122. 
  20. ^ a b Xu, Xiangcai (2000). Qigong for Treating Common Ailments. YMAA Publication Center. ISBN 978-1-886969-70-4. 
  21. ^ Ownby, David (2008). Falun Gong and the future of China. Oxford: Oxford University Press. pp. 181–186. ISBN 978-0-19-532905-6.