The 5 elements represent an essential but often overlooked aspect of our health.
When I started integrating them into my treatments, the difference was substantial for my patients compared to just treating them with TCM.
I also started receiving 5 element treatments for myself and the shifts I felt internally and saw externally were profound.
We all want the best for our patients and the 5 elements are an accessible way to help people transform their health.
Here are the top 3 benefits for my patients that I’ve noticed since incorporating the 5 elements in my practice.
#1 The 5 elements address the root cause
Finding and addressing the root cause is crucial to resolving our patients’ health concerns.
If we miss it or overlook it, we’ll be treating the same issues on repeat with no resolution. People will improve in the short term, but will gain little to no lasting change.
We can only treat the root cause if we see the whole of our patients. We can’t reduce our focus to their main complaint at the exclusion of other bodily systems and levels and expect that complaint to resolve.
Modern western medicine and to a certain extent, TCM, does just that. They dissect health issues into separate categories and apply treatments to each as if the categories existed in a vacuum.
For example, if you’re feeling tired and are experiencing a sluggish metabolism you may have your thyroid gland tested and be diagnosed with hypothyroidism. However, your endocrine system is a highly complex multi-glandular system that helps to regulate and is influenced by multiple bodily systems, many of which directly impact the thyroid’s health.
If you have excessive joint pain you may see a rheumatologist and get a diagnosis of rheumatoid arthritis and be given steroids or biologics to suppress your immune response and decrease your pain.
In TCM, if you’re easily frustrated, have strong PMS symptoms, have bloating in the upper area of your abdomen, and a wiry pulse, you must have liver qi stagnation and LV 3 and LI 4 will be used to break it up. If you’re foggy headed, feel heavy, tired, have a loss of appetite, and your pulses are weak and soggy, you must have spleen qi deficiency and SP 3 and SP 9 will be needled.
The question that needs to be asked is why are these imbalances occurring?
Why is the thyroid underfunctioning? Why is the immune system attacking the joints? Why is the liver stagnant? Why is the spleen lacking in qi?
You’ll never find an answer if you stay focused on the symptoms or syndrome patterns that your patient presents because they don’t represent the root cause of what’s occurring.
It’s easy to get lost in our patients’ symptoms because those are the issues that spurred them to seek out treatment. We want to address them as quickly as possible and help people feel better. But they’re not the origin of imbalance.
Symptoms are like breadcrumbs; they can lead us back to the source of our patients’ discomfort, but we have to be willing to take a step back and get perspective.
The 5 elements allow us to see the bigger picture
The 5 elements are a form of constitutional medicine, meaning that they contextualize the health issues we find in our patients within a larger organizing principle that provides a roadmap for comprehensive and personalized treatment. The larger organizing principle behind the 5 elements is the natural world. We can look to nature to understand our health, relationships, and personalities because the qualities of qi in nature are the same qualities that are within us.
The lens of 5 element constitutional medicine allows us to start with the big picture and see all of someone’s symptoms and syndromes as interrelated and that the whole is greater than the sum of the parts.
The 5 elements are part of our innate nature; they are at the core of who we are. They touch every aspect of our being and knowing them allows an unprecedented glimpse into the psyches and hearts of our patients.
An imbalance or dysfunction in our main elements, or our constitution, is regarded as the most fundamental imbalance a person can have in 5 element theory. The vast majority of health issues stem from this root imbalance and if it’s addressed properly, the signs and symptoms created by that imbalance will recede and resolve.
Case study: High blood pressure, sugar addiction, and exhaustion
A 45 year old female patient came to see me after she’d been recently diagnosed with high blood pressure. She was prescribed two medications which lowered her numbers, but she didn’t want to be on medication and her doctor didn’t have any other suggestions for her besides losing weight.
She was a self-described sugar addict and relied on it and caffeine to get her through her stressful job as a corporate lawyer. She had candy binge eating episodes which were brought on by stress.
She wanted to leave her job which she described as frustrating and extremely toxic but was very slow to make a change. She worked herself up so much by ruminating on her decision that she collapsed from exhaustion and couldn’t put one foot in front of the other to make the shift.
She saw another acupuncturist before coming to see me and reported that it had relaxed her, but that she noticed no lasting effect. She remembered that she was diagnosed with liver qi stagnation, damp, and spleen qi deficiency.
I observed that she did have all of those previously diagnosed TCM patterns, and I diagnosed her as an earth constitution. When I knew her constitution, I could view all of her symptom patterns through a larger 5 element lens.
When she ate sugar, it definitely created dampness in her system, exhausted her spleen, and contributed to her high blood pressure as a stimulant and irritant. But the sugar and stress weren’t the origin of her issues as we might think with TCM.
Her spleen and stomach were under more stress than other organs because she relied on them the most as part of her earth constitution.
Therefore they were the most likely to become imbalanced. This imbalance was the root cause of her issues and one that predisposed her to crave sugar, lack boundaries, and struggle to care for herself.
Signs her earth element was imbalanced:
- Inability to properly nourish herself – the sugar binge episodes were an attempt to fill the void/depletion she felt without being discriminatory about what she actually needed for fulfillment (spleen)
- Constant churning/rumination/obsession over her job and whether or not to leave (stomach)
- Lack of clear thought and intention around food, self-care, life goals, and work (yi, the spirit of the spleen)
When I treated her earth constitution, her spleen qi deficiency, damp, and liver qi stagnation signs improved.
Over the course of a few treatments deep behavioral patterns started to shift:
- her bingeing became less and less frequent
- her sugar cravings decreased
- she started to put up boundaries with her work
- she established self-care patterns like drinking enough water and exercising regularly that she wasn’t ever able to do consistently for herself before
Over a few months time, she finally had the focus and clear intention to leave her job. She started taking her own blood pressure readings and correlating the numbers to her environment, food, and stress levels. She told me that she felt more like herself, less overwhelmed, and more able to care for and prioritize herself.
Because constitution is at the center of us, it’s also at the center of our health.
If my patient’s sugar binges, high blood pressure, and lack of boundaries that left her exhausted were treated as separate issues or TCM syndromes, treatment would have (and did) just go in circles without affecting real change.
When we know our patients’ elements, we’re able to see the whole picture and distinguish between surface issues and the root cause. Treating the root cause and the whole person ultimately leads to better and longer lasting outcomes for our patients.
#2 The 5 elements help people become better versions of themselves
One of the major causes of disease according to 5 element theory is an unfulfilled life.
Lacking meaning and purpose dampens our spirit which results in anxiety, depression, stagnation, apathy, resignation, and a disconnection from nature, others, and ourselves.
Spirit-based issues impact all other levels of our health and are often neglected due to a lack of tools or resources or due to shame, guilt, and trauma. Many times people feel like there’s something that’s just broken in them and that’s their burden to bear.
The 5 elements are a spirit-based medicine and as a result they offer a solution to help alleviate that invisible, implacable heaviness of the soul that’s so common in our modern society. Spirit issues are overlooked by western medicine and TCM and they represent the vast majority of the problems people face in the modern western world.
5 element treatment is not considered successful until two criteria are met:
- Signs and symptoms improve
- The patient reports an improvement in how they feel about themselves
I can’t tell you the number of times someone has walked out of their treatment telling me that they feel like a weight has been lifted that they didn’t even know was there. They inexplicably feel lighter, have a more positive outlook on life, and are more connected to themselves and those around them.
When those spirit burdens are lifted, folks:
- Feel more confident and content with themselves
- Make better life choices that truly represent their interests
- Find purpose and meaning in life
- Connect with people and nature in a deeper way
- Experience their emotions as they arise and work through them rather than suppressing and denying them
- Attempt to work through a problem and move on when it can’t be resolved instead of resigning themselves to their circumstances
It might sound grandiose to say that 5 element treatment can help people live a better life as a better version of themselves, but clinically I’ve seen it happen too many times to discount. These transformations are my favorite part of practicing medicine.
Case study: Communication issues, depression, and fatigue
A 39 year old woman came to see me for anxiety, depression, and fatigue. She was 4 months postpartum, and had another young son who was a toddler. She was a full time writer before becoming a parent, and now she was the sole stay-at-home parent with two young children. She was completely overwhelmed and felt like she had lost her sense of self in this new role of full time motherhood.
She cried all throughout our first visit. Over the course of a few visits it became clear that the true undercurrent of her emotional distress was her disintegrating relationship with her husband. She felt like he never listened or communicated, was closed down, and couldn’t respond appropriately to her cries for help.
They started couples counseling and it became apparent after a few sessions that the communication issue went both ways. When difficult subjects came up, they both shut the other person out instead of engaging.
We discussed that this type of stress response is a classic defensive mechanism of the metal element, which was her primary constitution. I shared more information with her about metal and she felt like I had described her to a tee.
After realizing her metal tendency to shut down, she started seeing the pattern she’d created within her relationship.
She realized that once she shut down, the conversation was over even though her feelings weren’t resolved. She never circled back around to re-engage and instead suppressed the emotions that she needed to express. It was easier just to let things go than to build up the energy and courage to address them, even with her marriage on the edge of divorce.
Once she recognized this pattern and had a few 5 element treatments under her belt, she started to make positive shifts. She began expressing more to her husband, which inevitably brought up more conflict, but the conflict was crucial in order for them to finally work on their relationship.
She started prioritizing her own needs again and went back to writing for a day a week. She ended up starting a beautiful, art-filled children’s magazine with a good friend of hers and the light came back into her eyes.
I didn’t see her for over a year and she reached out one day to tell me that her family had moved to New Mexico to start a new chapter. She was still writing and she and her husband were building a house together.
The 5 elements help people break through emotional and spirit-based stagnation and disconnection in their lives because they provide a unique and needed toolset for supporting the deeper levels of the self.
If we’re not addressing the emotions and spirits of our patients, we’re not going to get very far in supporting their healing process. Their signs and symptoms may improve, but their outlook on themselves and their life won’t change and they’ll stay stuck in the same loops of resignation and self-protection.
When you incorporate the 5 elements into your education and treatment process, you’ll see your patients start to deepen their connection with themselves and appreciate more about their own rich internal world. As a result, they start showing up in their life as more satisfied and content people.
#3 The 5 elements connect us to the natural world
Another core cause of dis-ease in 5 element theory is living out of harmony with nature.
5 element theory uses nature as a major pathway to understanding people and illness. It not only recognizes the profound effect the natural world has on our health, but it also encourages us to see the similarity between ourselves and our environment and realize that we aren’t separate from it, despite all of our modern conveniences.
It’s very easy to become disconnected from the daily seasonal and climatic influences of the elements when we’re cozy and comfortable in our 72 degree conditioned indoor space. It's easy to believe that nature doesn’t impact our health.
When we live out of tune with nature, we’re living out of tune with ourselves
Since we carry the 5 elements of wood, fire, earth, metal, and water within us, we’re directly linked to the natural world. We’re a part of it and it’s a part of us.
Battling against inevitable elemental and seasonal influences is common but futile because we’re ultimately struggling against ourselves and creating more internal disharmony by shunning nature.
Instead of fighting inexorable natural forces, it's best to live with them and get to know them on a visceral, emotional, and spirit-based level. Because really, you’re just getting to know yourself.
When people are more connected with the natural world they:
- Feel more at ease within themselves
- Have an easier time finding meaning and joy in life
- Have less instances of seasonal depression even if a season is still challenging for them
- Look to nature as an ally rather than an enemy
Case study: Seasonal depression, quarter life crisis
A 26 year old woman came to see me primarily for gut distress and pain relief. She was an elite athlete who had traveled the world on climbing trips and had chronic loose stools after a more recent trip. She was still extremely active, was overtraining herself, and felt exhausted.
On the surface it looked like I’d be treating kidney deficiency, qi and blood stagnation, and spleen qi deficiency. But when we talked about her exhaustion, there was much more going on than what appeared on the physical level.
She worked for a corporate nonprofit which she hated. It paid the bills and allowed her to go on her climbing expeditions, but it was costing her a part of her spirit. She realized that she felt depressed when she wasn’t able to connect with and be in the natural world, and that mood change hit her the hardest in the winter time.
I started educating her about the 5 elements and their correlations with nature. She was a water constitution and I explained that the season of water is winter.
Winter is oppositional to much of US culture because it encourages us to slow down, rest, and recover with its yin energy. She was fighting against this natural inclination through her intense job and overtraining.
I explained that she would feel more acutely out of balance than other people during the winter if she wasn’t living in harmony with it because of her constitution.
Pieces started clicking into place for her once I had counseled her on the 5 elements, cleared 5 element blocks, and balanced her constitution.
She was able to:
- begin journaling regularly to process her emotions
- take up running as a way to be in nature more consistently rather than just on her big trips
- discover she was much more at peace with herself and stopped overtraining and started resting more
- begin coaching other athletes on the side as a means to leave her corporate job
After 2 years of building up a small client base, she left her nonprofit job for good and moved to a remote valley in the mountains where she is surrounded by nature. She is deeply satisfied with her work and runs, climbs, and gardens outside of her wooded home throughout the year.
She’s made a study of seasonal rhythms and teaches her athletes how to live in tune with them and train with them.
She embraces winter now and has no more seasonal depression. She even designed a program where she encourages her athletes to sleep and rest as much as possible during one month of winter to help them become more intune with its energy and restore themselves.
5 element treatment is one way to increase harmony with the natural world. Other options include:
- Spending time in nature observing it with all of your senses and noticing how you feel
- Spending time with your element in particular and observing its natural presence
- Practicing acceptance that nature can’t be controlled or cut out of your life
Living in tune with nature can have a profoundly positive effect on our health and wellbeing. We do our patients a great service by educating them about the seasons and the 5 elements and how these natural forces are an integral part of each of us.
There are many ways to help balance the 5 elements in your patients
So you might be thinking… ok, this sounds great! Now… how do I learn to balance my patients’ elements?
First, you have to know how to diagnose the elements, which takes training and practice and I run a mentorship program for just that purpose!
Once you’ve diagnosed your folks with the correct elements, if you’re an acupuncturist, you can balance their constitution with needles.
If you’re another type of provider, you can*:
- Do acupressure over constitutional points or have folks do it at home
- Talk about the elements and their associations with our health and personality
- Encourage folks to connect with nature and the seasons
*I also recommend and teach these methods for acupuncturists to augment their needling!
For over 10 years I’ve seen that balancing my patients’ elements has had a profound and lasting impact on their health and wellbeing.
I hope you’ll consider adding the 5 elements to your toolbox in order to support your patients’ whole self. Plus it’s really fun to watch them transform into a version of themselves they’ve always wanted to be with more ease than they ever expected.