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Stress – An investigation


Who doesn’t experience stress? It’s said that we are really only ever-stress free after we cease living. [i] After all it can be a valuable source of motivation and focus. However, most clinically stressed clients presenting in our clinic say “I’m stressed”, when stress really has gone beyond normal levels and it interferes with some aspect normal life. A common illustration of how stress is at first a positive influence and then a negative one is commonly described by the Yerkes-Dodson model. [ii]

Figure 1. The Hebbian illustration of the Yerkes-Dodson stress model [iii]


Familiar stress responses are; palpitations, butterflies in the stomach, hyperventilation, being “frozen”, or trembling. We, as practitioners, recognise the Fire, Earth, Metal, Water and Wood element view of the respective; Heart -palpitation, Stomach – butterflies, Lungs-hyperventilation, Kidneys-“frozen” and Liver-trembling correspondence from our knowledge of TCM.  Every channel exists in a dynamic balance with all of the other. So, for example, the classical Liver invading the Spleen & Stomach pattern is a result of one element of the Zang Fu system directly influencing another creating a stress symptom of hypochondriac or digestive discomfort.  This is of great diagnostic value as we conduct our consultation. Sometimes leading to a simple instant root cause diagnosis of stress from just listening out for the organ-symptom relationship.


Stress is extremely interesting from a biochemical perspective; but it divides somewhat into two distinct processes. That of acute response, and that of chronic. The acute one is the classic “fight or flight”, response. This is as a result of our hypothalamus being stimulated psychologically and, following nerve transmission to the inner centre of the adrenal gland (adrenal medulla), a release of the so called catecholamine hormones. Heart rate increases, blood flows from the digestive system to the muscles, respiratory bronchioles dilate and urine production is inhibited. The liver metabolism provides a spike of glucose to the bloodstream and blood vessels constrict resulting rise in blood pressure rise.  If we read through these responses in order, one by one we can identify our TCM organ correspondence to the biochemical process clearly – from Fire through to Earth, Metal, Water and Wood. The external (Yang) are prioritised over the internal (Yin) functions. The result of all of this is metabolic rate increases i.e.:- Yang predominates.

The chronic response to stress is a completely different pathway in the body. In fact it is the exterior of the adrenal gland (the cortex) that produces the so called adrenocorticoids. Blood sugar level is increased, the immune system is suppressed. Blood volume is increased and water is retained by the body through elevated sodium levels. These responses are somewhat more of a Yin nature. Yin predominates.

If, following our earlier example, the liver invades a deficient spleen / stomach over long periods then we can see how peptic ulcers and digestive problems can arise from stress.  We can see how for example through shock, producing a sudden excess in the heart influencing a weak lung, could produce chest tightness or asthma attack.  In both cases the primary stimulus of stress can manifest in other organs rather than that of the primary source. Could then acute stress responses (disruption of Qi) be correlated to the Western medicine biochemical response?  Additionally, could chronic biochemical stress responses be correlated to that of the classical TCM Five Element overacting sequence?

So for example, an acute short term anger response affecting the liver channel directly, and the chronic long-term stress response of anger affecting the spleen / stomach? That is, the primary organ associated with anger and the Five Element overacting spleen /stomach organs. The short term acute response of fear creating a “frozen” effect in the body, and the longer term response to extended fear weakening the heart?  Figure 1, compares the TCM organ emotions and the biochemical responses to acute and chronic stress.

Table 1:  Comparison of Acute and Chronic stress responses from a TCM and biochemical perspective.

Primary Organ Stimulated











Classical TCM Emotion / Stress Stimulus



Sadness / Grief



Acute Stress Response


Butterflies in stomach


Feeling or actually being “frozen”


Acute Biochemical response following Catecholamine release from Adrenal Medulla


Heart Rate Increase

Blood flow from digestive system to muscles

Bronchioles dilate

Sodium retention  with urine production inhibited

& sudden blood pressure change

Liver breaks down glycogen to glucose producing a energy spike in muscles


Overacted Organ in classical Five Element Theory












Chronic Stress Response

Shock -> Sadness / Grief (Feeling of loss, in this case loss of control)

Worry -> Fear (long term)

Grief (Loss) -> Anger

 -> Resentment (Chronic anger)

Fear -> Shock

Anger -> Worry

Chronic Biochemical response following Adrenocorticoids release from Adrenal Cortex


Immune Suppression

(Wei Qi)

Water Retention


Blood Volume Increase

Elevated Sugar levels




It comes as no surprise then to us, as practitioners, that our body’s’ perception and responses to stress are rooted around the adrenals and Kidney TCM function. Perception?  Our kidney’s role in our brain development and therefore source of perception.  Stress response? Through the Kidney core regulation of Yin and Yang and therefore the balance of Yin and Yang throughout the whole organ-channel system.

It appears then that stress results in our metabolism going into an accelerated state of “overdrive” and the  “weak link in the chain”,  presents as a symptom. Acute biochemical stress response corresponds to TCM organ-emotion response and chronic biochemical stress response to that of the classical TCM Five Element overacting sequence.  Though we know from literature and experience that trying to correspond TCM models directly to the biochemical view of the body often fails, it seems in the case of stress and stress responses at least there are very close parallels.

I’d love to hear your ideas, views about this article. Please let me know in our ACI blog at www.xxxxxxx.

This article is related to the upcoming ACI-UCC annual TCM lecture series. “Acupuncture, Stress and the Mind”, will be presented on 29th February 2012 at the Aula Maxima in University College Cork, starting at 5:30pm.

Written by Martin Fitzgerald MSc. Lic. Ac. M.A.C.I.


[i] Payne, R. (2005). Relaxation Techniques – A Practical Handbook for the Health Care Professional (3rd ed.). New York: Churchill Livingstone.
[ii] Payne, R. (2005). Relaxation Techniques – A Practical Handbook for the Health Care Professional (3rd ed.). New York: Churchill Livingstone.
[iii] 11/02/2012. 21.03 hrs GMT.

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