In China when one is ‘scared to death’, they say that the ‘hun flies and po scat-ters’. Hun and po are therefore terms that are still part of the common lan-guage: used in relation to powerful events, their disorder is dangerous.
A description of the clinical situation is more difficult. First of all, as usual, the traditional Chinese description and the biomedical description do not coin-cide or overlap with respect to the way that symptoms and signs are grouped and interpreted. Therefore every concept, definition or syndrome can only be referred back to the relative theoretical model. In the same way that altera-tions of po and hun do not correspond to established Western psychiatric mod-els, neither can they be assimilated into specific psychological structures.
Unfortunately, as acupuncturists, we often do not have a clear idea of the possible alterations of hun and po and their relative clinical consequences.
We may not know that much about qi, blood, channels and organs, but by now they are like old friends with whom we are familiar: we have an image of them inside of us and a frame of reference for treatment. Hun and po remain,
41 M. Granet, 1971, p. 299.
42 According to Eyssalet this polarity expresses the constant tension and conflict between the body, the darkness, the centripetal aspect and the expansion forces, the refining of our energy and spirit, the sense of totality of the shen. Gui are dangerous because of their egocentric character, their fixed quality and their predisposition towards fragmentation. While the cults regarding hun relate to ancestors, the sacrifices for po relate especially to relationships among human beings. The ‘gui are the main source of our relational problems and of our problems in general.’ (Eyssalet, 1990, p. 468).
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59 however, definitely more vague and elusive concepts that leave many of us
indifferent and many others somewhat frustrated.
Contemporary medical texts rarely treat the pathologies of hun and po specifically; rather, they are restricted to general discussions of man in the broadest sense, and areas where different levels of observation and practice intersect: physiology in the strictest sense, internal ‘alchemical’ practices of
‘nourishing life’, heterogeneous philosophical thoughts, and ritual ceremo-nies related to the cult of ancestor worship and popular beliefs. The hypotheses that follow derive therefore from classical descriptions of hun and po, from the integration of these images with the other aspects of traditional physiopathol-ogy and only lastly from the indications that come from clinical experience.
These hypotheses therefore require further verification, but nevertheless we can use them as a starting point for looking at theoretical and clinical work in Chinese medicine.
As we have seen, the Chinese viewpoint recognises various shen in the human being, which in some ways lead back to different orders of conscious-ness: two of these are po and hun, of which we have described ‘localisation’, origin, references, functions and manifestations.
Just as in the case of the yin–yang pair, pathology may initially affect only hun or po individually, but the ultimate result is an alteration of the dynamic balance between the two; finally the excess of one of the pair causes it to pre-vail, to the point that it becomes unable to express itself through interacting with the other. The isolation of either one of the two prevents movement and produces illness, whereas the natural state is that in which yin and yang enter one into the other, so there is a flowing integration and transformation of the various components (another frame of reference would define this condition as that state in which information circulates freely and permits a continuous readjustment of the system in response to internal and external changes).
Po, which relates to the dense, to matter, in everyday language represents strength, vigour and the condition of general health.
The classics also relate the strength of the body (form) to the vigour of po, which accompanies jing, the dense essence from which the body derives. ‘Jing is a turbid and heavy matter with its own consistency; form-xing is made of it.
Po is a function-yang that allows movement and action, the perception of pain and itching. Jing is born from qi, therefore if qi accumulates jing flourishes; po accompanies jing, therefore if the form is strong po is vigorous.’ 43
One can therefore see a weakening of po in those serious pathologies of a degenerative type, with strong genetic components in which we recognise a weakness of jing.
Jing is what precedes the forming of the body: ‘The two shen meet, unite and originate the form. This substance that precedes the body is called jing’.44
43 Zhang Jiebin, Leijing (‘ The classic of categories’, 1624), Book III, Chapter 9.
44 Lingshu, Chapter 30.
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Using a different frame of reference we can draw an anology between jing and the genetic code, and between po and its phenotypical expression.
Po regards the body but does not identify itself with the body: the descrip-tion of po which ‘can register and record internally’ refers to a type of con-sciousness which belongs to the body, which is its intelligence, its memory and its language.
Its pathologies are those in which the organism produces a dysfunctional response, for example autoimmune diseases, hypersensitivity and tumours, are pathogenic behaviours of the organism towards itself; in these conditions the body is confused, and lacks memory and recognition.45
In other cases dependence prevails, as if development had stopped at a sym-biotic stage – that is, like a po that did not separate from its mother po and did not reach autonomy. Of course, this element of dependence can be a bare hint or feature quite strongly; it can appear in love relations or manifest itself as compulsions, such as eating disorders or drug addiction.
When po predominates, it can end up functioning in an internally closed cir-cuit, losing the complementary polarity of hun and the integration of shen: this loss of movement and imagination naturally belonging to hun leads to clinical conditions in which elements of fixation, repetition and rigidity prevail.
These situations can seem very varied, but are linked by the sensation that only po exists, without the hun pole; we can detect disquieting repetitions in the clinical history, possibly not so much the symptoms themselves, but rather in the way they are told. The patient communicates a sensation of heaviness, when he speaks only of his symptom without being able to connect it with anything else, without being able to ‘move’ it in his mind. We can note an abnormal weariness in the conversation, which has an inflexibility that does not allow him to consider other possibilities or alternative routes.
Having lost the connection, interaction, and exchange with hun, po remains depleted of the movement-hun of thought; being incapable of integrating itself in the conscience-shen, it then shows only in more undifferentiated sites.
In the most serious cases, po thinking remains as primitive, concrete thinking, with no access to the symbolic realm.
Since it is also po which establishes our relationship with the outside world – that which allows us to perceive, move, and express ourselves, ‘the perception of eyes and ears, the movements of the hands and the feet, the sound of crying and breathing’ – when a person perceives, elaborates and expresses himself only through the body, this is a sign that po is overwhelming and the comple-mentary activity of imagination is relatively lacking. This situation is seen in somatic disorders, in which the person is unable to bring the suffering into
45 A similar interpretation can also be found in contemporary medical texts, in which po is said to include also ‘every compensatory function regarding the regulation of biological activities’, for example in the article by Zao Youchen, in: Liaoning zhongyi (‘Spirit therapy with traditional medi-cine’), 1979.
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61 the mental realm. Therefore, it can only be expressed through the body, which
then manifests the symptoms, but without the capacity of expounding on them: the passage of po in the shen is lacking.
The isolation of po, however, can impede the expression of hun and shen not only with regards verbal expression, but also in their actions, leading to situ-ations where the individual acts without thinking. This dynamic can assume many different forms: it can manifest in a tendency to restlessness, that is an internal agitation which pushes one to ‘do’ continuously in order to relieve the anguish, to the expression of feelings using only gestures and actions rather than thought and words, the inability to explain oneself can lead to risky behaviour (violence, abuse and mistreatment towards oneself and others) and it can be seen in repetitive ‘acting out’ during psychotherapy sessions.46
If hun – ‘the movement of dreams’ and ‘pertaining to the fluctuating states’ – is inadequate, then all that remains is the solidity of po, with the various types of lack of imagination described above.
A weakness of hun can also cause insufficient flow of emotions: if the move-ment that enables the emotions to circulate is deficient, they cannot harmon-ise and mutually balance, and a single emotion can easily dominate, becoming inflexible and stuck.
The example of the spleen – an organ which has functions of transform-ing and transporttransform-ing and is related in the wuxtransform-ing system to thinktransform-ing and worrying – can be helpful. Thinking means also worrying and taking charge but if the spleen does not function then digestion – of food as well as thoughts – suffers, leading to a tendency to brood, to the point of turning into a clinical obsessive–compulsive disorder.
Hun is yang; in various texts it is from time to time called external light, fire, the flame of po (which is its root), qi of heaven that ‘governs movement and action’ and is also defined as ‘that which gives rise to action’: these are characteristics related to the essence of movement, they express that which is furthest from matter – that is, pure mental activity.
Whereas po can be traced to the conscience of the body, hun ‘belongs to dreams and sleep, trance, mutating hallucinations, fluctuating states’; it cor-responds to what we know through the imagination, ‘in dreams there is activ-ity, but the body does not correspond’.
46 Also called acting out, they indicate ‘the attempt of the patient following an analytic treatment to avoid confronting himself with his unconscious conflicts, searching for solutions at the level of real-ity’ (Galimberti, ‘Psychology dictionary’, Dizionario di Psicologia, 1992, p. 19). They show themselves both in behaviours outside the treatment and in actions such as being late for or missing sessions.
In a psychoanalytic sense this type of action denies the secondary process which is characterised by stable representations that allow the deferring of the satisfaction based on the reality principle.’ We have highlighted how shen derives from the union of the virtue-de of the heaven–father with the qi of the earth–mother. But in this case, where the law of order is denied (the fatherly is also ‘the third, the outside’ that breaks the dual symbiosis with the mother and opens towards the social-ity) and the time deferring the desire is excluded, the imbalance of hun and po corresponds to an absence of the heaven, to an absence of the clarity of the word-law (de) as opposed to the darkness of the earth (the material, nourishing qi ). It corresponds to an annihilation of time (the heaven of the round back of the turtle).
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62
If, therefore, the equilibrium of the pair hun/po is lost, hun becomes iso-lated, the ‘spirit of movement’ which does everything by itself; its link with the denser and more material mental aspect is broken and hun feeds back only to itself, resulting in mental activity without any relation to actual reality.
Severed from the boundaries imposed by matter, the imagination of hun remains isolated, to the point of creating its own perceptions by hallucinat-ing.47 We can therefore see extreme pathologies of hun in psychotic condi-tions, with their hallucinatory forms. However, since hun follows shen, ‘the progressively acquired consciousness’, and if shen is lost, hun fluctuates and goes wandering without return, leading to a detachment from reality and logi-cal thought – that is, to true delirium.48
Imbalances of hun are also found in less extreme but more frequent cases:
we find clear traces of it where patients lose contact with internal and external reality, their responses no longer fit the situation, mood and feelings swing dangerously, and the body suffers.
In fact, hun is tenuous, it ascends, it tends to disperse, it ‘fluctuates’ when life is exhausted, and its excess can affect the body: ‘Just as the flame burns matter, hun can consume jing’.49
This image suggests a dynamic in which an excess of thought consumes matter, losing contact with the real and concrete. This excess with regards to imaginative thought can substitute reality with illusion and block its recogni-tion as such. It can also be identified with a sort of spirituality that denies the needs of the body, as happens in anorexic patterns. It can furthermore mani-fest as a rationalisation that denies the perception of emotions.
However, the potentials of hun and po, and the existence of particular states of consciousness are not merely pathologies. In the internal practices linked to mystical ecstasy, the attainment of enlightenment presupposes a state of
‘empty heart’ – a state through which the ‘critical point between life and death’
can be reached. This process is described as a separation of yin and yang (an event that normally implies death), a transformation that happens in dreams – in other words in an altered state of consciousness. In dreams one can be transformed, but in waking life one cannot: this is the separation of the unity of yin and yang; this separation comes from emptiness, whereas unity comes from full-ness. This is a sign of hun and po and in reality it embodies the subtle distinc-tion between life and death. ‘If one manages to completely empty his heart,
47 ‘All of a sudden it as if the body is splitting into two people, but only the one self can see the other’. In: Chen Shiduo, Shishi milu, (‘Secret notes of the stone chamber’), chapter ‘Lihun’ (‘ The leav-ing Hun’).
48 See also the systematisation of the contemporary psychiatrist Zhang Mingjiu, Chapter 21.
He focuses on the relationship between shen and the disorders of the conscience, speech and thought (for example deliria), and between hun, perception disorders (classified on the basis of the alteration of time, space, own body, hallucinosis, hallucinations) and affective area disorders (indiffer-ence, paradox reactions, emotional instability, anxiousness, aggressiveness, euphoria, etc.).
49 Taiyi jinhua (‘ The secret of the golden flower’ ), Chapter 2.
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63 then it will be clear and still, and in dreams one will reach the critical point
between life and death and his consciousness will reach great depths’.50