The Yin and Yang of Social Phobia

Q:I feel that I am experiencing social phobia symptoms (red face, racing heart, sweating) and don't want to take a prescription drug with a bunch of bad side effects that will only mask these symptoms. I'm very interested in Chinese medicine but feel that I may be the person it has no effect on. I'd like some more information on overcoming anxiety and social phobia so I may live again. I'm probably yang deficient but no one would expect me to say that nor would they think I'd even be the one asking for info about overcoming anxiety.
- Ryan

A: Ryan, did you read our social phobia article yet? (http://pulsemed.org/Socialphobia.htm)

Are you looking for more detailed lifestyle-type solutions? Are you suspicious that Chinese Medicine won't work for you because you've tried Chinese Medicine before, or are you just afraid of the disappointment? What makes you say you think you are yang deficient? Help me target my response to you with answers to these questions. All the best, B

Q: Hi Brian, I don't exactly know why I feel I'm yang deficient, I know very little about chinese medicine. But from my extensive readings on the internet about the symptoms I've been experiencing (red face, racing heart, constant heat, sometimes with uncontrollable sweating, nervousness--social phobia). I feel I'm exerting many of what I understand to be yang deficiency symptoms.

I'm not really shy but feel I'm really under a lot of pressure especially when around strangers or making a first impression. I'm hoping to overcome this without Western meds. that have too many terrible side effects. As far as lifestyle changes, I've been doing practically the same things I've always done, but now everything is just much harder in general, and the social phobia of whatever kind may be to blame. If you have any recommendations about changing this naturally, I'm all ears.

I've never tried a chinese medicine before, I just am skeptical about the true intentions of a lot of on-line doctors/therapists that are quick to perscribe something for someone they do not know or really care about.

Not to sound like a Mr. Know-it-all, but I'm a graduating with a Marketing minor soon and know a lot about advertising and marketing schemes. This being a problem many Americans face makes it all the more enticing for someone attempting make a quick buck from desperate people. But I do not feel this way about your organization and as I said, I know very little about Chinese medicine. I'd like to find something that works for me and hope you'll talk with me some more.

Thank you very very much for your time and understanding
Sincerely, Ryan

A: Ryan, thanks for your clarification, and your feedback.

I keep hearing about online doctors... I haven't looked into this, so I can't speak to that. But yes, the internet and my email inbox are full of marketing messages.

The Pulse's major goal is to raise public awareness about Chinese Medicine. We take part in a few affiliate programs (Amazon.com, The Diet Forum) but these are peripheral, and do not influence our writings. We are committed to the highest ethical standards- which I have discussed in this article. (10 guidelines article)

Yin and Yang Deficiency
So, let's talk about yin and yang deficiency. Yin is passive and cool. Yang is active and hot. Thus, a yin deficiency is a lack of coolness and passivity which leads to "hot" symptoms... feelings of heat, restlessness, etc. Yang deficiency is a lack of heat and activity, so it appear "cold"... feelings of cold, diminished function, tiredness, etc.

However, diagnosis is not so simple. Yin or yang symptoms can be due to deficiency or excess. The ones above are just the deficiency kind. A yang excess would be hot and overactive. A yin excess would be cold and sluggish.

Diagnosis in Chinese Medicine
I'm going to run you through a hypothetical Chinese Medicine diagnosis- just for your information- you should find a Chinese Medicine physician in your area and consult them for treatment. I don't know all the facts of your case, so I can't substitute for a one-on-one consultation. To find a Chinese Medicine physician, go to this page.

Your symptoms are "red face, racing heart, constant heat, sometimes with uncontrollable sweating, nervousness--social phobia"

The red face, racing heart, constant heat, and uncontrollable sweating are all heat symptoms. So are they yin deficiency, or yang excess? In yin deficiency, sweating is usually at night and correlates with a feeling of heat in the palms and feet. In yin deficiency, usually only the cheeks are red... whereas in yang excess the whole face is red. In yin deficiency, feelings of heat are in the afternoon or evening.

It appears to me you more likely have a yang excess.

The 8 Principles of Chinese Medicine
Up to now, we've only talked about 6 of the 8 principles. The 8 principles are a general categorizing system for diagnosis... They are

internal/external
cold/hot
deficient/excess
yin/yang

One Chinese physician proposed adding downward/ upward direction to this, for a total of 10 principles.

So for you - so far - we have: yang, hot and excess.

Is the Disease Internal or External?
Causes of external heat are usually viruses, flu's etc. And external diseases are usually recent, not chronic. Nor do they often have severe emotional effects... unless they've been around for a while and caused other internal problems. Usually emotional issues are due to internal causes. Sources of emotional trauma may be external, but the disease processes are still considered to be internal. I'm going to assume your disease is internal, but if your symptoms are only a recent development, then an external pathogen is a possibility.

Zang Fu Syndromes of Social Phobia
Now, if we take our 8 principle diagnosis of internal, hot, excess, and yang over to the article on Social Phobia... in particular the section on Zang Fu syndromes (opens another window for reference)

We see 5 Zang Fu syndromes listed. The first two are deficiency. The last three are excess. So, we can further differentiate by seeing which symptoms of your fit those syndromes. Here is where Tongue and Pulse diagnosis become key, and where a one-on-one with a Chinese Medicine practitioner is indispensable. Also, I don't have enough information from you to make this further differentiation.

Just for your information, the 5 Social Phobia Zang Fu patterns in terms of the 8 principles are:

Heart and Kidney Yin Deficiency = internal, hot, yang, deficient
Spleen and Heart Qi and Blood Deficiency = internal, no temp, yin, deficient
Heart Fire or Excess Heart Yang = internal, hot, yang, deficient and excess
Phlegm Fire Disturbing the Heart = internal, hot, yang, excess
Liver Heat and Blood Deficiency = internal, hot, yang, deficient and excess

Diagnosis by Zang Fu vs. Diagnosis by Type
Now, these 5 Zang Fu syndromes are not the end-all-be-all... this is what is called "diagnosis by type." It is not exactly the same as "pattern differentiation." It's a process by which we start with a disease (in this case Anxiety), and look at what Chinese Medical scholars believe to be the differential diagnosis. This style of diagnosis is fairly new... so it is in development. But it's a good place to start.

Once we have a type, we can take the representative herbal formula and modify it more specifically to you. This part is based on pattern differentiation and a knowledge of the actions of various chinese herbs. There are hundreds of herbs to choose from. We can fine-tune your formula over a few visits to eliminate side effects. For more about how herbal medicine can be effective without side effects, read the article, "Healing Without Side Effects?"

One on One Help
Probably the best thing for anxiety would be to see a Chinese Medicine physician who can get you the right herbal formula, and give you acupuncture to regulate your nervous system.

Other Helpful Therapies for Social Phobia
Along with this, it would be good to see a counselor who can guide you through some self-reflection about your social phobia... especially if it's been a recurrent part of your history.

It may take all three of those things- and in addition to the counseling, prayer and meditation can be powerfully transformative. It's not easy to confront deeply held fears, and mistaken ideas about ourselves and the world, but it's well worth it. You can't really run from them- not in any constructive way. They'll just hang around and wait for you to deal with them... and you won't be happy until you do.

In fact, wasn't it Eleanor Roosevelt who said that the best way to destroy fear is to do the thing you are most afraid of? Try toastmasters - most people are more afraid of public speaking than death! Toastmasters is a support and learning group for public speaking, and the first lesson is how to use the fear to your advantage!

BEST WISHES in your healing... and if I can help further, please let me know.

All the best,
B