Zou huo ru mo

Zou huo ru mo (Chinese: 走火入魔; pinyin: zǒuhuǒrùmó) or qigong deviation (Chinese: 氣功偏差; pinyin: qìgōngpiānchā; lit.: 'qigong deviation/error' or Chinese: 气功出偏), is a Chinese-culture concept traditionally used to indicate that something has gone wrong in spiritual or martial arts training. The qigong community uses this term to describe a physiological or psychological disorder believed to result during or after qigong practice, due to "improper practice" of qigong and other self-cultivation techniques. The concept was highlighted in the social and political context of mass popularization of qigong in China.

Background

The Chinese word zǒuhuǒrùmó (Chinese: 走火入魔 "①be obsessed with sth. ②possessed by the Devil") combines zǒuhuǒ(r) ("①〈elec.〉 ⓐspark ⓑhave a short circuit ②〈coll.〉 discharge (a firearm) accidentally ③overstate ④catch fire; be on fire") and rùmó ("①be spellbound ②be infatuated/obsessed").[1] In recent times this syndrome has been known as qìgōngpiānchā (Chinese: 氣功偏差 "qigong deviation/error"). 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.[2][3] Most cases do not last for an extended period of time, and are never brought to medical attention.[4]

While qigong could potentially act as a stressor in some vulnerable individuals, relations between qigong and disorders are manifold, and causal relationships have not been demonstrated.[5] Similar syndromes have been observed in other forms of self-cultivation practices such as yoga (Kundalini syndrome),[6] meditation,[7] and hypnosis.[8]

Symptoms

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.[2]

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.[9]^:165–167

Diagnosis

While the Chinese Society of Psychiatry prefers the term "qigong deviation", the American Psychiatric Association uses psychosis terminology.[10] Some physicians believe that this disease can be categorized as a culture-bound syndrome, but this point is debated.[3]

Chinese psychiatry

In the second edition of the Chinese Classification of Mental Disorders (CCMD-2) published by the Chinese Society of Psychiatry[11] the diagnosis of “Qigong Deviation Syndrome” is based upon the following criteria:[12]

• 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.

Western psychiatry

In the West, there was no equivalent experience until the adoption of qigong practices by the public became more common. 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.[13][14][15][16]

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.[17]

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.[18]

Medical causes

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.[19]

Latent psychosis

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;[19] a type of reactive psychosis or the precipitation of an underlying mental illness, such as schizophrenia, bipolar disorder, or posttraumatic stress disorder.[20]

Qigong community perspective

Within the qigong community, Zou huo ru mo is believed to be caused by improper practice:[21]

• 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)."

Treatment

Within the qigong community, there are specific treatments believed to be effective for addressing different forms of Zou huo ru mo.[21] 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. Clinical treatments can involve psychological counseling, expert guidance of practice, acupuncture, massage, "external qi" treatments, and symptomatic correction.[9]^:164–173

Social and political context

Qigong deviation became part 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".[2][22]

References

1. Translation equivalents from Wenlin, Version 4.2.2, 2015.
2. 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 978-0-231-12804-9.
3. Shan, HH (2000). "Culture-bound psychiatric disorders associated with qigong practice in China" (PDF). Hong Kong J Psychiatry: 10–14.
4. Lee, Sing (December 1996). "Cultures in psychiatric nosology: the CCMD-2-R and international classification of mental disorders". Culture, Medicine and Psychiatry. 20 (4): 421–472. doi:10.1007/bf00117087. PMID 8989986.
5. Ng BY. 1998. "Qigong-induced mental disorders: a review." Australian & New Zealand Journal of Psychiatry 33(2):197-206.
6. Upadhyaya, Pt.Rajnikant (2006). Awake Kundalini. Lotus Press. p. 26. ISBN 978-81-8382-039-4.
7. Nelson, James M. (2009). Psychology, Religion, and Spirituality. Springer. p. 470. ISBN 978-0-387-87572-9.
8. Gibson, Hamilton Bertie (1991). Hypnosis in therapy. Psychology Press. ISBN 978-0-86377-155-2.
9. Liu, Tian Jun; Qiang, Xiao Mei, eds. (2013). Chinese Medical Qigong, Third Edition. Singing Dragon. ISBN 978-1848190962.
10. Liu, Lydia He (1999). Tokens of exchange: the problem of translation in global circulations. Durham, North Carolina: Duke University Press. p. 315. ISBN 978-0-8223-2424-9.
11. The Chinese Society of Psychiatry (1989). "66. Qigong deviation syndrome". Chinese Classification and Diagnostic Criteria of Mental Disorders (CCMD-2). CCMD-2.
12. Human Rights Watch (2002). Dangerous minds: political psychiatry in China today and its origins in the Mao era. New York, New York: Human Rights Watch. ISBN 978-1-56432-278-4.
13. DSM-IV-TR, American Psychiatric Association, p. 902
14. 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.
15. Vuong, Ngan Kim (2006). "Cultural Bound Syndromes: Qigong Psychotic Reaction". In Jackson, Yo (ed.). Encyclopedia of Multicultural Psychology. Sage Publications. pp. 142–143. ISBN 978-1-4129-0948-8.
16. Sandhu, Daya Singh (1999). Asian and Pacific Islander Americans : issues and concerns for counseling and psychotherapy. Commack, New York: Nova Science Publishers. p. 231. ISBN 978-1-56072-663-0.
17. 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. PMID 17932733.
18. Robinson, Bruce H. (2007). Biomedicine: A Textbook for Practitioners of Acupuncture & Oriental Medicine. Blue Poppy Press. p. 434. ISBN 978-1-891845-38-3.
19. Robinson, Bruce H. (2007). Biomedicine: A Textbook for Practitioners of Acupuncture & Oriental Medicine. Blue Poppy Press. p. 435. ISBN 978-1-891845-38-3.
20. 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.CS1 maint: multiple names: authors list (link)
21. Xu, Xiangcai (2000). Qigong for Treating Common Ailments. YMAA Publication Center. ISBN 978-1-886969-70-4.
22. Ownby, David (2008). Falun Gong and the future of China. Oxford, England, UK: Oxford University Press. pp. 181–186. ISBN 978-0-19-532905-6.