Using the Law of the Five Elements to Restore Balance and Regulation in Trauma Survivors
By Alaine D. Duncan, MAc, DiplAc
This article was originally published in the Fall 2022 edition of the AIM Newspaper. Read the full paper or subscribe to the print edition for free.
Our medicine is a perfect match for the needs of trauma survivors. It is rooted in restoring balance and regulation. It can help reconnect disturbed pathways. It works below the level of cognition and helps people feel more embodied and become more present and self-aware. Trauma is vibrational illness and acupuncture is vibrational medicine.
Traumatic stress is defined not by the causal event but by the response of an individual to their experience. Trauma is anything we perceive as life-threatening, that overwhelms us, and leaves us altered and disconnected from our bodies. I like this definition: “Too much, too fast, without adequate support.”
Traumatic stress creates profound dysregulation in every body system. It is easy for acupuncturists, trained with an orientation to diagnose and treat symptoms, to get lost in the diverse and enigmatic dynamics these patients present with. However, treating discrete symptoms separate from attention to restoring core regulation and balance will not bring these patients “home” to themselves.
Trauma gives rise to unpredictable and unusual physiology and clinical outcomes that are often not accounted for in acupuncture training programs, in spite of their common presence in our patient population. We have a special role to play, a special diagnostic lens to look through and so much to offer.
Our practices are filled with people with the “strange, rare, and peculiar” symptoms emblematic of the dysregulation in the autonomic nervous system caused by traumatic stress. Symptoms such as insomnia; chronic pain; metabolic and digestive disturbance; obesity; problems with memory, cognition, or mood; interpersonal challenges; and autoimmune illness or endocrine disorders, often intertwined as “complex, multi-symptom illness”, nearly impossible to tease apart as discrete phenomena.
The foundation of the Tao of Trauma model for transforming the impact of traumatic stress rests on these principles:
- Two-legged and four-legged animals navigate danger using the same five steps we will call the Self-Protective Response.
- These five steps, defined by neurobiology, are mirrored in the 5 Elements (of course!).
- Symptoms arise when the energetic impulse in any step is thwarted or remains incomplete.
- Successful completion of all 5 steps of the Self-Protective Response mitigates trauma’s imprint.
- An incomplete step will influence where the dysregulation of qi caused by trauma impacts and may remain in our body-mind-emotions and spirit.
- The correspondences of the 5 Elements can guide our diagnosis and treatment of trauma survivors.
Here is a thumbnail of the role of the 5 Elements in the context of the Self-Protective Response:
Metal and Autumn – Awaken Arousal. The spirit of the lung, called the po or “animal soul”, ensures sensate awareness. We are able, with embodied awareness, to notice that something is amiss. Our arousal is awakened; our senses become alert and focused on this phenomenon so we can assess whether it is threatening.
Water and Winter – Signal Threat. The Water Element’s vulnerability and capacity to communicate fear signals life threat. Its association with the kidney/adrenal system provides both the energetic and biochemical signaling of the presence of life threat. Fear is a consuming messenger.
The Water signals the pericardium, via control cycle, that we need help from our tribe! However, if our capacity for social engagement has been wounded by previous relationship-based threats or the sheer magnitude of this threat, the heart is penetrated and a whole-body response is initiated. That message is sent via the heart blood.
Wood and Spring – Mobilize A Response. The energy of spring, mirrored in the Wood Element, is reflected in the sympathetic nervous system. It supports us to orient to threatening circumstances, plan our escape, and feel empowered to mobilize a fight-or-flight response for our protection. The liver alerts our sense organs to orient to threat. Our joints, tendons and ligaments are prepared for fight or flight. The liver sends messages via the control cycle to the stomach/spleen to temporarily shut down digestion to support mobilization.
Fire and Summer – Restore Coherence. Upon successful negotiation of threat, the Fire Element gives us a heartfelt recognition that we have moved through the awaken arousal, signal threat, and mobilize response phases successfully. It signals this with a regulated, coherent, and invisible heartbeat, creating a sense of peace, equanimity, and propriety in the entire kingdom of the body.
The liver sends the message to the heart that allows its rhythm to be restored to equanimity. Liver cools, liver yin is restored. Benevolence returns to the liver. The freeze response melts, kidney yang is restored. Balance is restored in the kidney/heart axis. Co-regulation between yin and yang returns. Lung rhythm is restored. Regulation and peace are restored in the kingdom of the body.
Digest the Gristle- Earth and Late Summer. The Earth Element signals our body to restore peristalsis, the contractions in the walls of the digestive organs that push digested food onward. No matter how successful our negotiation of danger or life threat, there is always some “gristle” to digest and some choices about the lessons we harvest. We break down and harvest the lessons that can nurture us in future challenges, should they arise in any one of these phases. The Earth Element helps us to integrate these lessons into the flesh of our existence.
Return to the Metal. As we flow naturally through the integration of our experiences, we return to the open, sensate curiosity associated with the Metal. We take time to savor the feeling of success, victory, and pride in overcoming obstacles and proving ourselves strong enough to survive a challenge. We acknowledge the self-confidence we have earned. We can now return to curiosity and exploration—of our environment, of other people, and of the beauty we find in our perfect world.
I would challenge protocol-driven treatments as not being very helpful for trauma survivors. A lightning bolt hitting a tree affects every bug in its bark, bird on its branches, bush crushed by its fall, and soil disturbed by its uprooting. When we are similarly hit by a lightning bolt, our recovery may require quality minerals, water, new sprouts, warm sun, or good soil. All Five Elements—Metal, Water, Wood, Fire, and Earth—may be required to restore regulation.
Similarly, trauma survivors can get tripped up in any one of these five steps and in the dynamics of both the shen and the k’e cycles. We can ask ourselves:
|Western Terms||Chinese Medicine Terms|
|Has the brain stem hijacked the neo-cortex?||Has the Water overwhelmed Fire? Has the heart been penetrated?|
|Is the neocortex unable to reassure the brain stem?||Has the Supreme Controller lost capacity to reassure the kingdom and provide equanimity?|
|Is there a thwarted sympathetic arousal/ mobilization remaining in body memory?||Is there liver qi stagnation or liver blood deficiency?|
|Did the freeze response shut down peristalsis in the guts?||Is there an accumulation of dampness in the spleen or deficiency of spleen yang?|
|Has the freeze response shut down the respiratory diaphragm or the bronchi?||Is there deficiency of lung qi?|
Even more important than helping us manage acute danger or life threat, cultivating the capacities of the 5 Elements can help us live more fully and more harmoniously with our fellow humans and the earth. Consider the opportunities the 5 Elements provide us with to contextualize the tasks before us as a world community, and to help transform the divisiveness, polarization, and violence we witness.
|Element||Capacity||Queries To Consider|
|Metal||Awakens Arousal – cultivates capacity to recognize something new in our environment.||Do you maintain a state of open curiosity and mindful awareness of what is here and now? Do you find yourself scanning for threat?|
|Water||Signals both Safety and Threat – gives us the capacity to distinguish discomfort from fear.
|Can you distinguish discomfort from fear? Is your capacity for tolerating discomfort growing or shrinking? Are you more convinced by your chemistry or your curiosity?|
|Wood||Mobilizes a Response – and ensures that it is commensurate with level of threat.
|Are your impulses for self-protection attuned to the level of threat you are actually experiencing in this moment? Can you find a moment of time between stimulus and response?|
|Fire||Restores Coherence – communicates danger and equanimity, and gives us the capacity to recognize that the crisis has passed.||Can you embody your experiences of success in your self-protective response? Do you recognize that “it’s over” and can you return to a state of equanimity?|
|Earth||Digests the Gristle & Harvests the Lessons – ones that expand rather than contract our life experience.||Do you harvest lessons that expand rather than contract your life experience?|
Interested in more? Come to the Pacific Symposium, or join my year-long, five-session, 70 CEU Tao of Trauma course. Find out more: https://integrativehealingworks.net/the-tao-of-trauma-2023/
Alaine Duncan is an acupuncture clinician, educator, and researcher. She has a passion to integrate the wisdom of Chinese medicine with the study of neurobiology and traumatic stress in both the classroom and the treatment room. It has carried her heart and hands to places and people she never imagined when she graduated from Maryland University of Integrative Health in 1990 and completed Somatic Experiencing training in 2007. Her book The Tao of Trauma: A Practitioner’s Guide for Integrating Five Element Theory and Trauma Treatment is the foundation for classes and workshops she offers for acupuncturists, somatic psychotherapists, and bodyworkers.
Alaine was a founding member of the Integrative Health & Wellness program at the DC Veterans Administration Medical Center, where she served as a clinician and researcher from 2007-2017. Her research background includes serving on studies assessing the impact of integrative medicine on compassion fatigue in military caregivers, and the use of acupuncture for the treatment of combat-related traumatic stress, chronic headaches in OIF and OEF Veterans with traumatic brain injuries, pain in veterans of all conflicts, and for Gulf War Veterans Illness.
 Alaine D. Duncan and Kathy L. Kain, The Tao of Trauma: A Practitioner’s Guide for Integrating Five Element Theory and Trauma Healing (Berkeley: North Atlantic Books, 2019.