Prescribing Nature

Image source: Applied Channel Theory in Chinese Medicine: Wang Ju-Yi’s Lectures on Channel Therapeutics by Wang Ju Yi and Jason D Robertson.

Last time I checked, it’s still summer and I hope you are all finding ways to enjoy it. We have much longer daylight hours and that make getting outside a little bit easier this time of year. In fact, a recent study showed that spending a total of two hours, or 120 minutes, a week outside can greatly benefit your health and that Doctors are actually prescribing “time in nature.”

This prescription may seem absurd to some but it’s refreshing to see allopathic medicine acknowledge the importance of the natural world to our health. When I decided to study Traditional Chinese Medicine (TCM) and Acupuncture, one of the things that appealed to me was how the body was conceptualized and accepted as part of nature. Coming from a background of studying and teaching environmental literature and nature writing, I had no problem with these ideas: we are nature and our bodies are microcosms of the greater environment we inhabit. Living is a constant negotiation between the two.

The benefits of being outside are wide-ranging: “A wealth of research indicates that escaping to a neighborhood park, hiking through the woods, or spending a weekend by the lake can lower a person’s stress levels, decrease blood pressure and reduce the risk of asthma, allergies, diabetes and cardiovascular disease, while boosting mental health and increasing life expectancy.” This is quite a list! We treat all of these conditions in our clinic weekly. While it may be tempting to think that even more time outside would lead to even greater benefits, researchers have found that is not the case. Even more interesting about their findings is that the two-hour dose cut across economic, gender, and ethnic demographics, as well as those with pre-existing health conditions: “Two hours a week was the threshold for both men and women, older and younger adults, different ethnic groups, people living in richer or poorer areas, and even for those living with long term illnesses.”

While many people may not be able to drive to Sequoia or Lake Elsinore for the weekend to spend time in the trees or by the water, they can still get the benefit of connecting with nature by walking around their neighborhood, sitting on their balcony, getting out to their local park, or strolling along the beach.

How one defines nature these days is certainly debatable, as I often hear people from LA say they need “to get out into nature.” But I believe nature is all around us, even if it seems there’s more concrete than trees. When you get yourself outside, look around. What trees are there? What flowers, animals, or insects? Researchers don’t exactly know why these experiences outside create these salutary effects, but some theories are that getting outside requires physical activity, encourages interaction with others, and invites us to take time away from our devices and screens. Paying attention to the external world, gives us a break from the never-ending stream of thoughts that dominate our minds. I suspect those tenets of TCM can help us understand this too: connecting with the outside world is a way to connect the inside world.

Consider this prescription, no matter your health issue. Go outside, get off your device, for two hours a week? Let me know what happens!

Five Phase Theory: Into the Fire Phase

Have you ever wondered why we overwhelmingly deal with colds in the fall and the flu in winter?  As practitioners we often notice a connection between seasonal change and a rise in specific health conditions.  This observation is explained well by a foundational theory of Chinese Medicine known as the Five Phase or Five Element Theory.  Five Phase Theory  builds on these vital connections between nature and our health by centering the idea that our spirit and health are interwoven with our surrounding environment.  Specifically, it breaks the year down into five seasons, noting our traditional 4 of Spring, Summer, Fall and Winter with the addition of late summer as the fifth.  And it draws relationships between the five elements - Wood, Fire, Earth, Metal, and Water -  assigning each a season, organ energy, emotion, virtue, taste, and pathology.  Five Phase Theory is useful because it provides helpful information to anticipate issues for individuals who are inclined toward one element more than another. This method of diagnosis helps us help you stay balanced during seasons that can be particularly aggravating to your constitution.

Click the image above to make it bigger.

Photo source: HOPPER ACU.

With the recent summer solstice, the Fire Phase is now underway.  Fire is a dynamic, warm, charismatic, joyous and fast paced force that draws us into our hearts.  So it is the perfect season to spend time out and about and among one another, taking joy in all the activities around us.  However, it can stir imbalances especially in those who may already have an excess amount of fire or heat in their constitution.  A fire imbalance might cause any number of symptoms like palpitations, itchy skin, manic episodes, anxiousness, hyper vigilance, and even restless sleep.  This is a time that we do experience a rise in the above symptoms and we have been able to treat them successfully at LBCA.

Temperature often plays a major role in causing these seasonal symptoms.  It has a tendency to stir the mind and quicken blood circulation.  The nature of heat is yang with a rising quality.  When it travels in the body, it naturally rises upward toward the head.  This aggravates the mind, enabling episodes of irritability, mania, and beyond.  As these are easily uncomfortable sensations, they can also trigger the nervous system to heighten into fight or flight.  Heat can also travel outward and when it does, it can cause eruptions on the skin by way of rashes or bumps.  When we regulate heat and encourage the production of body fluids with acupuncture and herbs, it eliminates these issues powerfully. 

During these summer months, it follows that patients complain most often about emotional disturbances like anxiety, vivid dreams and insomnia.  In past years, Susan and I have also observed multiple cases of patients with manic episodes.  We have found that regular treatments reduce their duration and intensity.

This season there has also been an uptick in skin related issues. One patient recently showed me a series of red itchy bumps that have spread across her ribs and abdomen. They occur every summer and appear to cause her discomfort, despite their benign nature.  With two treatments there is a notable change in redness and itchiness.  More treatments will likely restore her skin to its previous state as we improve her circulation, reduce the heat in her body, and promote fluid production. 

In this fiery season, if you start to experience any of these symptoms, please don’t hesitate come in for treatment.  Acupuncture and herbal remedies may be just the right answer to your needs as you move through this phase of the year!

Anxiety & Allergies: How Acupuncture Can Treat Both

Allergies and anxiety are two of the main complaints we treat daily at Long Beach Community Acupuncture. This year both conditions have been extreme: while I can’t exactly say why the rise in anxiety has occurred, I can attest to our very wet winter, followed by an amazing super bloom. An unfortunate byproduct from all of this beauty has been terrible allergies for people who are susceptible--everything from runny nose, watery eyes, blocked ears, and itchy skin.


The New York Times column, “Ask Well,” explored the link between allergies and anxiety recently, beginning with the question: “Are my allergies all in my head?” The relationship between reactions has been documented as early as 1883. While they do not claim that “emotions and stress” actually “cause” allergies, they do suggest that allergies can worsen anxiety. And the ENT doctor from the nineteenth century noted that “‘attacks of prolonged sneezing are most apt to occur in persons of nervous temperament’” (4/02/2019, D4).


Western medicine describes the mechanism for allergies this way: “In all allergies, the immune system overreacts to certain antigens (called allergens) that are harmless in most people. It is a common immunity mistake because the system is tuned for ‘zero tolerance’ . . . it cannot let a harmful substance slip by its protective barriers and it may overreact in the process of surveillance” (Bruce H. Robinson, M. D., Biomedicine: A Textbook for Practitioners of Acupuncture & Oriental Medicine, 2007, p. 460).


Thinking about allergies as an over-reaction and the immune system as one of “zero tolerance” is a provocative idea. Anxiety, too, is also a kind of over-reaction or hyper-stimulation of the nervous system. One of our great modern teachers of acupuncture and Chinese medicine, Richard Tan, shared this notion in a continuing education class on “Stress, Insomnia, and Depression.” In describing a diagnostic pattern, he links the impulse to over-react to stress and allergies. (He also links expectation and depression in interesting ways but that is for another blog.)


Taking his class, I was struck by the connection, remembering one of the last severe allergy attacks I had. Santa Ana winds had been blowing, and I was commuting to work on my bicycle; however, I had also experienced a recent, strong emotional reaction (one might say over-reaction). By the time I had gotten home, my head felt sealed up from nostrils to vertex--like cement--nothing moved and it was hard to breathe. I was miserable and it made for poor sleep.


In retrospect, I wouldn’t say that stress caused this particular physical response--as I have had seasonal allergies all my life--but they did occur in succession. More importantly, I have begun to think carefully about my emotional output and how my sinus reacts. Exploring this mind-body connection, I check in to measure my responses and to ask--am I working in a mind-set of “zero-tolerance”?

This greater awareness has been helpful to me overall. Allergies and anxiety are normal responses to existing, and each day presents a new set of circumstances to navigate, both internally and externally. If your daily life is severely impacted by either reaction, it is an indication that you need help. Becoming aware of your patterns of response is an important part of managing anxiety and allergies. Acupuncture can make a difference, especially frequent treatments. Acupuncture assists in calming the nervous system and regulating body functions. At our clinic, we have seen great results in helping people manage these reactions. Remember that “[o]ne-third of all people in the U. S. have at least one allergy” (Robinson, 460). The next time you have a flare up of anxiety or allergies, see what you notice. Which came first? Did one condition aggravate the other? And know that we are here to help.

Community Acupuncture and Trauma-Informed Care

This month to celebrate POCA’s membership drive, we’d like to share a great blog post from one of community acupuncture’s founders, Lisa Rohleder. In it, she discusses how community clinics, like ours, are informed by trauma-informed care. At LBCA, we believe it’s an essential approach in making people feel comfortable and providing compassionate healthcare.

Follow this link to find out more:

Reflections From a Forced Hiatus, Part II

Just last Thursday, my podiatrist released me from care, and I am so happy to be back at the clinic, seeing all of your lovely faces, and hearing about your lives! I really missed all of the interaction while I was at home recovering from my bicycle accident.

Last month, I shared how much I learned from this experience and the lessons keep coming. Certainly acupuncture and herbs really helped me deal with pain and swelling and supported my bones in healing, but there were many other things that really made a positive difference.  If you have had a similar experience or know someone with an injury, I wanted to share what helped me through.

In general, I operate on the belief that “you don’t give to get.” You do what you do without expecting anything in return. So I was awed by the care so many of you showed me when this happened. My accident occurred blocks away from the clinic. After Ayla picked me up, two long-time patients, who had arrived for their appointments that day, thought nothing of loading me and my broken foot into their car and taking me to urgent care. They stayed with me through the entire process of x-rays and assessment, then took me home and helped me get settled. It was so kind and such a relief to have people I have known for 5 years taking care of me. I am a little embarrassed to admit that it was unexpected, though perhaps, it shouldn’t have been.

During this process, others offered help, though I was a bit shy of taking them up on it. I--like many people--find it very difficult to ask for help. If someone you know is in a similar situation, keep this in mind; they may need it more than they know and just may find it hard to ask or even accept. Sincerely offering help and being ready to follow through counts!

My spirit was buoyed by the many get well cards I received. In our days of social media and virtual everything, paper cards are so touching. I arranged them like you might holiday cards, keeping them around to inspire me to fully recover. It was healing to know I was loved and missed in my darkest moments. Physical injuries have an emotional component--important to remember and acknowledge with people you know who are suffering.

Emails, texts, along with Facebook and Instagram messages were also nice too. Being housebound and immobile was so isolating, so when my phone would register a text or email, it broke up many hours of being alone with my thoughts. Connecting with those who are injured can feel like a balm to them, and any form they can access is likely welcome, so don’t assume you will be bothering them.

Some sent flowers, which were a bright, happy addition to my healing environment. Friends stopped by with food and conversation--truly welcome for our whole household. My dear spouse lovingly bore the brunt of caregiving; still, he was glad to have a few meals taken care of that he didn’t have to prepare.

There were many jokes about Netflix binges, and while I am no purist when it comes to this, I saved it for evenings. I indulged my acupuncture nerdiness with some new books on the subject, but I could only read so much of this, as not being able to practice in the moment easily triggered my sadness at not treating people.

I read various books on mindfulness and meditation: Tara Brach’s Radical Acceptance (2003), Haemin Sunim’s Love for Imperfect Things (2018) and The Things You Can See Only When You Slow Down (2017)--all of which helped me accept my current situation.

For entertainment, I read Tara Westover’s Educated (2018), Barbara Ehrenreich’s Natural Causes (2018), and I am still working through Lian Moriarty’s Nine Perfect Strangers (2018).

Switching from reading to listening, I found certain podcasts mentally nourishing: Tara Brach’s offered a true life-line for self-reflection; Shankar Vedantum’s “Hidden Brain” informed and entertained, and Krista Tippett’s “On Being” provided an amazing mix of interviews that inspired.

I did crossword puzzles and made a healing vision card of healthy right feet doing activities I planned to return to. I even signed up to participate in a five day bicycle ride in September that raises money for the California Bicycle Coalition to ensure I would get back on my bike.

While my injury is one that healed, other people you know may be living with a disability every single day. Consider what you might do to make their lives a little easier and a little less isolating. If you have had a similar experience, I’d love to hear what helped you heal. Our office manager, Ayla, loves the Ram Dass quote, “We’re all just walking each other home.” Indeed, we are. How can you do that for someone you know? Even someone you don’t know so well?