For a long time, Traditional Chinese Medicine (TCM) has studied the balance between human emotional activities and physiological states. One of the holistic views in TCM is the harmony of the human body, including the harmony between mental states and the external environment. TCM believes that emotional activities are closely related to changes in the internal organs (五脏, wǔ zàng) and six bowels (六腑, liù fǔ). When emotional activities are excessive, intense, or prolonged, they exceed the body’s normal adaptive capacity, affecting the function of internal organs and leading to diseases. This type of disease induced by emotions is referred to as “emotional disorders” (情志病, qíng zhì bìng).

TCM categorizes normal emotional activities into seven types, known as the “Seven Emotions” (七情, qī qíng), which are joy (喜, xǐ), anger (怒, nù), worry (忧, yōu), contemplation (思, sī), sadness (悲, bēi), fear (恐, kǒng), and shock (惊, jīng). These seven emotional changes are based on the internal organ meridians (经气, jīng qì) as their material foundation. Excessive emotions can directly damage the corresponding organs and have related clinical manifestations. To address emotional issues, one can only resolve them through thought adjustment, gradual awareness management, and self-cultivation.

A normal person encounters various situations in daily life, experiencing a little happiness, a little anger, a little sadness, and a little fear, which do not harm the body. Only excessive emotions can affect the body. Emotional fluctuations influence the movement of Yang Qi (阳气, yáng qì) within the body, and different fluctuations have varying effects on the trajectory of Yang Qi. The “Huangdi Neijing” (黄帝内经) summarizes this: “Anger causes Qi to rise, joy causes Qi to be gentle, fear causes Qi to descend, shock causes Qi to be chaotic, sadness causes Qi to dissipate, worry causes Qi to gather, and contemplation causes Qi to stagnate.”

TCM Seven Emotions – Anger Causes Qi to Rise

When one is angry, the energy of Yang Qi rises, which is why some people turn red in the face during heated arguments. This is due to Yang Qi pushing blood upward, causing a sudden rush of blood to the face, resulting in redness. An interesting term from ancient China is “anger raises the hair” (怒发冲冠, nù fà chōng guān). The hair is considered a surplus of blood; thus, when a person is angry, the blood rushes to the head, causing the hair to stand up and even lifting the hat. Although this is an exaggerated description, it reflects the widespread understanding of this phenomenon in ancient society.

Ordinary people, after getting angry, can harm the liver and gallbladder, especially those who bottle up their anger, as it can easily lead to liver Qi stagnation (肝气郁结, gān qì yù jié). The process of anger actually consists of two stages. The first stage is liver Qi stagnation. When you are angry about something, your body becomes very agitated, causing your liver Qi to stagnate immediately. The second stage is venting. When the liver detects its meridians are blocked, it attempts to eliminate this stagnation, causing Qi to surge upward, and people express their emotions through words and actions.

Those who bottle up their anger remain in the first stage without reaching the second stage, so their frustration and anger cannot be released. If liver Qi stagnation occurs unexpectedly, it is not a major issue, as the body can self-regulate. When a person sleeps, the body can automatically clear some negative emotions. These stagnant emotions may be released in the form of gas; for example, some people feel very frustrated but feel comfortable after sleeping or after pressing and massaging certain acupuncture points (穴位, xué wèi). Although the body has the ability to self-clear, if you frequently feel frustrated, the clearing ability may not be fast enough, leading to increasingly severe liver Qi stagnation, resulting in symptoms such as chest fullness, loss of appetite, nausea, and bitter dry mouth, which occur due to liver Qi not flowing smoothly and gallbladder Qi reversing.

TCM Seven Emotions – Joy Causes Qi to be Gentle

Joy is beneficial to the body. The “Huangdi Neijing” states: “Joy harmonizes Qi and reaches the will, nourishing and benefiting the body, thus Qi is gentle.” When a person feels joy, the movement of Yang Qi throughout the body becomes very smooth. Any unfavorable situations suddenly become smoother, and previously accumulated depression is immediately eliminated, so Yang Qi does not run too fast or too slow. Note that in TCM, “gentle” does not mean slow; it means a state without disease or slowness.

Once Yang Qi flows smoothly, it can better nourish the skin, hence the saying: “A smile makes you ten years younger.” People who maintain a joyful disposition not only stay healthy but also appear younger. Some say that those who laugh often have many wrinkles. In fact, this is not true. Wrinkles form when muscles are relaxed and Yang Qi is insufficient to reach the face. Long-term lack of nourishment from blood and water, along with the warming effect of Yang Qi, causes the skin to become dry and wrinkled. For instance, even when children laugh, they do not develop wrinkles because they have abundant Yang Qi. However, excessive joy can lead to sadness. For example, some people faint upon hearing they have won a prize. Any overly high emotion can harm the body. Too much happiness causes Qi to not be gentle but rather slow. Have you ever felt that after a hearty laugh or during a moment of great joy, you feel less motivated to do anything? This is a state of lethargy that occurs when Qi slows down.

TCM Seven Emotions – Fear Causes Qi to Descend

Some people turn pale after being frightened due to a decrease in blood flow to the face, while others may lose control of their bladder due to a drop in Yang Qi. If the Yang Qi below is weak, the urethra and anus cannot be controlled, leading to the expulsion of feces. This is more common in the elderly, as they lack Yang Qi.

The kidneys (肾, shèn) are responsible for storing the essence of the body, which is necessary for bodily development. When a person experiences excessive fear, Yang Qi descends, leading to incontinence. In fact, even the essence of the kidneys can be expelled with urine, resulting in a decrease in kidney essence. Some individuals are very weak or experience extreme fright. When they lose control, they expel all their essence from the kidneys, leading to cases where some people have died from fright.

Do not think that only sudden fright can harm the kidneys. When a person is frightened, they may not be as terrified as when they lose control, but a small portion of essence from the kidneys may unconsciously be expelled, as a small amount of essence may seep into urine and feces, which will be expelled during normal bathroom visits. If a person remains in a state of fear for a long time, the essence of the kidneys will gradually seep out. Therefore, those who are in a prolonged state of fear will appear pale and lack energy. On one hand, they may become angry due to fear, and Qi and blood will not flow to the face. This is a long-term state of fear, where Qi gradually dissipates, leading to insufficient essence, and thus the spirit will not be supported by Qi, resulting in dullness.

TCM Seven Emotions – Sadness Causes Qi to Dissipate

Some sadness may not last just one or two days but can persist for a long time, such as after a breakup. As mentioned earlier, sadness causes Qi to dissipate; when a person is in a state of sadness, their Qi will dissipate.

Long-term sadness, especially that which leads to excessive crying, can easily lead to insufficient Yang Qi, making the body’s resistance very weak. Some individuals who are usually weak may faint while crying. For patients who remain in a state of sadness for a long time, recovery is not easy, as Yang Qi has been consumed by the emotion of sadness. If Yang Qi does not return, recovery from such diseases will be difficult. Sadness can also harm the lungs (肺, fèi), as when a person is sad, the lung Qi immediately tightens, preventing the lung Qi from regulating, and some turbid Qi and phlegm cannot be expelled. Over time, waste gas accumulates. The tightening of lung Qi can lead to lung diseases.

Many ancient stories record that some people died months after losing a spouse or parent. This is due to excessive consumption of Yang Qi, leading to the accumulation of pathogenic Qi within the body, resulting in fatal diseases.

TCM Seven Emotions – Contemplation Causes Qi to Stagnate

When a person thinks excessively, Qi will accumulate. This is because all of the body’s attention is focused on the problem at hand, causing Yang Qi to concentrate in the brain. Due to the prolonged concentration of Yang Qi, much of it remains in the brain. Over time, Yang Qi becomes stagnant there and is not easily dispersed.

The concentration of Yang Qi in the brain can lead to one of the biggest downsides: insomnia. Many people have experienced this; when mental activity is excessive for a period, the brain unconsciously continues to think and ponder things at night. Even when returning to the present, everything reappears in the mind. As a result, one cannot fall asleep all night. Even if they do fall asleep, they may have restless dreams. This is due to Yang Qi being in the brain, preventing the heart spirit from sinking into kidney water.

When people think too much, the transportation, transformation, and digestion capabilities of the spleen and stomach (脾胃, pí wèi) decrease. Since Yang Qi is concentrated in the brain, the spleen and stomach will consume their own vitality for a long time in an energy-deficient state. Those who like to think or are forced to think often have poor spleen and stomach function. Everyone can reflect on the period of intense study during high school; during that time, did the function of the spleen and stomach decline? Sometimes they may even lose their appetite, or even if they can eat, they feel weak.

Since the spleen and stomach are the source of postnatal Qi, they digest food and metabolize the acquired Qi to help maintain human spirit and daily activities, most of the body’s organs are nourished by the spleen and stomach. Additionally, the spleen and stomach classify the essence of food according to the different nutrients required by each organ, and then provide them accordingly. Therefore, individuals with long-term poor spleen and stomach function may have yellowish muscles, easily fatigue, and frequently fall ill. This is not only due to Yang deficiency but also due to malnourishment of the five internal organs. Thus, it is essential to balance work and rest, avoid excessive thinking, take breaks, and completely relax without getting stuck on one problem.

TCM Seven Emotions – Shock (Fear) Causes Qi to be Chaotic

Shock and fear are often linked, but shock primarily refers to the disturbance of the spirit, leading to unease, as in the term “startling” (惊心动魄, jīng xīn dòng pò), while fear is more about being afraid. Therefore, sudden fright can cause a person to be unsettled and unable to calm down to think, leading to chaotic Qi. At this time, if you check their pulse, it will be erratic, and the person and their thoughts will be in a disordered state.

Frequent Qi deficiency can easily lead to the formation of blood stasis, causing Yang Qi to remain on the skin to protect the body. It is worth mentioning that children are particularly susceptible to fright. After being startled, they may cry at night or appear panicked. This disturbs their thoughts, preventing them from settling down. You can give them a small amount of calming herbs.

TCM Seven Emotions – Worry Causes Qi to Accumulate

The last emotion is worry, which arises when the mind cannot balance with reality. Worry is the concern that bad things will happen, while contemplation is the expectation that good things will happen; both reflect a contradiction of thinking about the future when it has not yet arrived. Our hearts can only deal with the present, and if the heart is focused on the future or distant matters, it will enter a state of helplessness, leading to feelings of worry.

When you worry, Qi will accumulate. Yang Qi initially spreads within the body to protect it. Now, when it accumulates, it causes insufficient Yang Qi on the body’s surface, making one prone to illness. If you spend the entire year in such a state of worry, you will develop liver Qi stagnation. This is detrimental to the liver, spleen, and stomach.

TCM employs various methods to treat “injuries from the Seven Emotions”. There are herbal treatments such as classic TCM formulas like Xiao Yao San (逍遥散, Free and Easy Wanderer Powder) and Si Ni San (四逆散, Frigid Extremities Powder) that target excessive worry and Qi stagnation, Gan Mai Da Zao Tang (甘麦大枣汤, Licorice and Jujube Decoction) for sadness and mental confusion, and Zhi Zi Hou Po Tang (栀子厚朴汤, Gardenia and Magnolia Bark Decoction) and Long Dan Cao Tang (龙胆泻肝汤, Gentian Decoction) for irritability and heat. Acupuncture and massage therapies can also be used, but it is essential to combine these with psychological counseling from doctors and self-regulation by patients.

TCM treatment emphasizes the principle of “Three Factors for Treatment” (三因治宜, sān yīn zhì yí), adhering to the principles of treating according to time, place, and person, and developing personalized treatment plans for different patients with emotional disorders is key to showcasing the characteristics of TCM and ensuring clinical efficacy.