Zou huo ru mo (medicine)
Zou huo ru mo (走火入魔) or "qigong deviation" (氣功偏差) is a Chinese term applied to a psychological and physiological disorder, associated with improper practice of qigong and other self-cultivation techniques. This condition is characterized by the perception that there is uncontrolled flow of qi (life energy) in the body. Other complaints can include localized pains, headache, insomnia or uncontrolled spontaneous movements. Some physicians believe that this disease can be categorized as a culture-bound syndrome, but this point is still debated.
What is zou huo ru mo?
The term zou huo ru mo ( 走火入魔 ) literally means "catching fire entering demon". In recent times this syndrome has been known as "qi gong pian cha" (氣功徧差) meaning "qigong deviation". The term has traditionally been applied to indicate that something has gone wrong in one's martial arts training, and in more recent history to refer to undesirable effects experienced during or after the practice of the broad range of Chinese self-cultivation exercises known as qigong. Similar syndromes have been observed in other forms of self-cultivation practices such as yoga (Kundalini syndrome), meditation, and hypnosis. Symptoms are often identified as being in one of the following three categories:
- perception of uncontrolled movement of qi in the body,
- sensory problems such as visual or auditory hallucination, and
- belief that the practitioner is controlled by qi or other entities such as spirits or negative energies.
When a qigong practitioner experiences a negative reaction during or after qigong exercise, the practitioner can seek help from within the qigong community or treat the experience as a psychological problem. Within the qigong community, the negative reaction is explained using the theory of qi. In psychology, both the Chinese Society of Psychiatry and the American Psychiatric Association have diagnostic guidelines to determine the practitioner's condition. The difference between the two psychiatric viewpoints is that in China, the psychiatrists do not use the psychosis terminology; preferring "qigong deviation".
In the second edition of the Chinese Classification of Mental Disorders (CCMD-2) published by the Chinese Society of Psychiatry the diagnosis of “Qigong Deviation Syndrome” is based upon the following criteria:
- 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 neuroses.
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.
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.
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.
There are many explanations for the appearance of those symptoms during or after qigong practice. The explanation differ depending on the viewpoint. In the Chinese qigong community, the symptoms indicate inappropriate qi circulation. In the psychiatric community, the symptoms indicate a latent psychosis.
Within the qigong community, various causes of qigong deviation have been identified. For example:
- Inexperienced or unqualified instructor
- Incorrect instructions
- Becoming frightened, irritated, confused, or suspicious during the course of qigong practice
- Inappropriate manipulation or channeling of qi
In cases of psychosis, the Western psychiatric view is that qigong is a precipitating stressor of a latent psychotic disorder to which the patient is predisposed, rather than erroneous qigong practice; a type of reactive psychosis or the precipitation of an underlying mental illness, such as schizophrenia, bipolar disorder, or posttraumatic stress disorder. 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.
Within the qigong community, there are specific treatments for addressing different forms of qigong deviations. Most cases do not last for an extended period of time, and are never brought to medical attention. In Western psychiatry, antipsychotic drugs may be prescribed.
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