Can Bad Emotions Really Cause ‘Mysterious Illnesses’? — Doctor Luo Dalun: Western Medicine Calls It Somatic Symptom Disorder, Chinese Medicine Calls It Stagnant Liver Qi

Opening: A Mystery Illness That Will Leave You Guessing

Today, before we talk about any formulas, let me tell you a story. It took place in a large hospital, where a veteran Western-medicine department chief had trained two disciples — both young physicians at that hospital. And between these two fellow students unfolded a tale of grudge and rivalry as absorbing as that of Pang Juan and Sun Bin, the two students of the legendary strategist Guiguzi in ancient times.

💬 Note from Doctor Luo: The younger disciple was the clever one. While studying under their teacher, he was forever tripping the older one up — pulling the stool out from under him, as we say. When the teacher’s birthday party came around, for instance, he might simply forget to tell his senior. The senior would find out far too late and arrive when it was already over, and the teacher would be displeased — thinking the senior disciple was thoughtless. After enough of these incidents, the teacher gradually cooled toward the senior, decided he was unpromising, and instead valued the junior highly. The senior was entrusted with less and less.

Naturally, the senior was furious. Fine — if you will not teach me, I will teach myself. He pulled out the hospital’s archives and read them again and again, and his clinical skill grew at an astonishing pace. He had truly thrown himself into it.

💬 Note from Doctor Luo: When the old chief finally retired, the senior disciple — whose academic record really was outstanding — became the department director himself. Middle-aged now and holding real power, he began to repay his junior’s earlier kindnesses, keeping the man perpetually suppressed: no work assigned to him, no beds for his patients. The junior was bitterly frustrated, with no hope of promotion. Around that time another department in the hospital was being set up, where he could have spread his wings — he asked to transfer to get away from his senior. But the director refused: I won’t release you. The director was a leading authority in the field, so the hospital could do nothing about it. Every avenue for advancement was now closed, and day after day the pressure continued. You can imagine what that state does to a person.

Then one day, the junior disciple suddenly came down with a strange illness: he abruptly lost his voice, could not breathe properly, and his limbs would no longer move — he could not even walk. He went for tests: nothing much wrong with any of his indicators. He went to other hospitals: the same, no cause found. Everyone asked — what on earth is this disease?

The Answer: Western Medicine Calls It ‘Somatic Symptom Disorder’; Chinese Medicine Calls It ‘Stagnant Liver Qi’

Doctor Luo Dalun says, we will not comment here on who was right and who was wrong in that story — but we should understand the illness. This was caused by stagnant liver qi — emotional constraint — and the fact that emotion can produce consequences this severe is very real.

💬 Note from Doctor Luo: Western medicine has a whole field of psychology, and it has given this kind of illness a name: somatic symptom disorder. It means bodily dysfunction brought on by bad emotions, anxiety, and the like. The scope of it is extraordinarily wide — everyone should remember this.

How does Chinese medicine look at it? We call it gan qi bu shu — stagnant (constrained) liver qi. What are its typical signs? A bitter taste in the mouth, a dry throat, dizziness, a quiet reluctance to eat, alternating chills and fever, vexation with a tendency to vomit, insomnia with vivid dreams… Behind these symptoms lie several body systems at once:

💬 Note from Doctor Luo: A bitter mouth involves the sense of taste; not wanting to eat involves the digestive system; vexation involves the emotional system; the tendency to vomit is digestive nausea; dizziness and headache involve the nervous system; fullness and pain in the chest and flanks often involve the nervous system and the heart’s circulatory system; insomnia and vivid dreams involve the nervous system. Do you see? The Shao Yang pattern that Doctor Zhang Zhongjing described all those centuries ago — what we today call stagnant liver qi — overlaps with this considerably. It is a disorder involving the disturbance of many systems at once. And if we add easy sighing, constipation or diarrhea, and abdominal pain, we find that bad emotions, anxiety, anger, and depression provoke reactions all over the body.

So what is the precise definition Western medicine gives to somatic symptom disorder?

💬 Note from Doctor Luo: Its hallmark is the presence of one or more — often many — bodily symptoms that recur and change frequently, and that can involve any system and any organ of the body. Yet when you examine the patient with modern medical instruments, no organic lesion supports them: you say your stomach hurts terribly — surely the gastric disease must be serious? They check: nothing. At most a mild superficial gastritis, nowhere near enough to explain it. But the patient keeps seeking treatment over the long term, keeps feeling awful. This is somatic symptom disorder — a refraction of bad emotion onto the body.

Many such patients see doctors for years, running from hospital to hospital, never finding a cause. They suffer terribly, some grow steadily worse, and end up as startled birds — afraid of their own shadow.

💬 Note from Doctor Luo: I meet patients like this all the time. In the morning: Doctor Luo, my hands feel swollen — what should I do? The next day: now this hurts. The symptoms change faster than you can follow, yet no clear cause can be found — and the patient himself is exquisitely sensitive to every twinge. There are a great many such people. Today I want to give you a systematic summary: which symptoms may actually be somatic symptom disorder driven by stagnant liver qi.

Family One: Pain That Cannot Be Explained

First comes pain. Sometimes it is in one spot, sometimes in a cluster; the range is very broad.

💬 Note from Doctor Luo: Headaches, for example — people with constrained liver qi and pent-up emotion get headaches. Also neck pain, abdominal pain: some people ache in the belly for no apparent reason — angry, the stomach hurts; tense, the stomach hurts too. What is that abdomen? We call it the gut brain — the digestive tract is packed with neurons that sense emotion, so your bad moods land in your belly. Then there is back pain, joint pain, limb pain, chest pain, rectal pain — a portion of all these pains is tied to bad emotion.

Such pain also has a characteristic: it is unfixed, or it flares in a rhythm — around menstruation, during sex, when urinating, when passing stool. And some pain appears specifically after episodes of anxiety or stress.

Family Two: Gastrointestinal Symptoms — the Liver Overacting on the Spleen

The second great family is gastrointestinal symptoms: belching, hiccupping, nausea, vomiting.

💬 Note from Doctor Luo: Western medicine holds that these digestive complaints are tied to bad emotion. We in Chinese medicine sum it up in one sentence: the liver qi runs rampant and attacks the spleen and stomach — gan qi heng ni ke pi tu — driving the stomach qi upward. People often ask me: what should I do about my reflux esophagitis? Why does the acid keep surging upward? Very often it is emotional: the liver qi is constrained, it runs wild against the spleen and stomach, the stomach qi cannot descend and goes up instead, and stomach acid bathes the esophagus — that is reflux esophagitis. Some of it climbs all the way to the throat, bathing it again and again, and that sets off chronic pharyngitis — a portion of chronic pharyngitis is caused precisely by stomach acid rising like this.

Then there is abdominal pain and bloating — gas bubbling and darting around in the belly. That is disordered qi movement, and in Chinese medicine it is what the Xie Xin Tang (Draining the Heart) family of formulas treats. And then constipation or diarrhea:

💬 Note from Doctor Luo: Different emotions change digestive motility in different ways — when you are tense, this stretch speeds up; when you are grieving, that stretch is inhibited and slows down. Fast here, slow there, and the gut falls into chaos, so sometimes diarrhea, sometimes constipation. A whole digestive system thrown out of order is, to an enormous degree, linked to bad emotion. Many of our stomach ailments — gastric ulcers among them — are tied to bad emotion.

Family Three: Urogenital Symptoms — the Liver Channel Wraps Around

The third family is urogenital symptoms: difficulty urinating, urinary retention, frequent urination; discomfort and pain around the genitals; and some male sexual dysfunction.

💬 Note from Doctor Luo: The moment sexual dysfunction comes up, everyone says kidney deficiency. Let me tell you: truly kidney-deficient cases are very few. A very great many are tied to emotion — to psychology, willpower, depression. Why? Because of the course of the liver channel. The ancients said it winds around the genitals — rao yin qi — meaning its pathway passes through, even encircles, the reproductive and urinary systems. So when liver qi is constrained and depressed, the areas the liver channel passes through run into trouble — especially female reproductive function.

The most obvious example is menstruation — the period is completely tied to emotion. Many women, the moment they have a bout of anger, their period changes at once: it suddenly stops, or amenorrhea sets in. Everyone should remember that.

Family Four: Pseudo-Neurological Symptoms — Suddenly Unable to Move, Speak, or See

The fourth family is pseudo-neurological symptoms: ataxia, limb paralysis or weakness, difficulty swallowing.

💬 Note from Doctor Luo: Some people suddenly feel they cannot swallow — eating and drinking normally, then all at once, pop, they choke, and cannot get anything down; it appears in an instant. And there is the very common plum-pit qi (mei he qi) in women: while eating, they feel as if something is stuck in the esophagus or throat, as if something has not gone down — ancient Chinese medicine called this mei he qi. A perfectly smooth physiological act suddenly has its rhythm disrupted. Then there is suddenly losing one’s voice — like the junior disciple in our opening story. And urinary retention: urinating normally, then suddenly unable to pass water. And loss of touch and pain sensation: some patients suddenly cannot feel that hot water is hot, can put their hand in scalding water without flinching. Such patients really exist — I have seen them.

And there are even more alarming versions: double vision, sudden blindness — one moment they can see, the next they cannot; sudden deafness — hearing vanishes; and strange skin sensations — some feel their skin is on fire, some feel ants crawling, some feel stabbing pains. Yet when examined, no corresponding organic damage to the nervous system can be found.

And the most severe of them all? Limb paralysis.

💬 Note from Doctor Luo: Just like the junior disciple in the story at the beginning — no other cause at all, only suppressed emotion, and then one morning he woke up unable to move — paralyzed. My goodness, you say, can it really be that serious? Yes, exactly that serious. People may see fewer such cases now, but in the past, in the countryside, you would often hear of a woman arguing with a neighbor, and in the middle of the quarrel she suddenly collapsed and could not move, lying in bed completely paralyzed — that is a case of this type.

Family Five: Respiratory and Circulatory Symptoms — the ‘I’m Dying’ Sensation

The fifth family is respiratory and circulatory symptoms: chest tightness, short breath, difficulty breathing, a sense of suffocation, oppressive chest pain — even a feeling of impending death — oh no, I am done for, I am dying.

💬 Note from Doctor Luo: Such patients are exquisitely sensitive to their own heartbeat — fast or slow, strong or weak, they feel it all. The more they focus on it, the more sensitive they become; the more sensitive, the more frightened; the more frightened, the worse the symptoms. This is different from the da qi xian xian (sinking of the chest qi) I discussed earlier: in that condition the qi is genuinely deficient, and tonifying cures it. Here tonifying does nothing — after taking supplements they still feel short of breath, the heart racing and chaotic, breathing difficult. This symptom cluster is related to the chest-flank fullness, chest tightness, and palpitations summarized in the Chai Hu (bupleurum) family of formulas.

The Key Point: Autonomic Nervous System Dysregulation in Somatic Form

Among all these symptoms, the heavier kind is autonomic nervous system dysregulation in somatic form. What does that mean?

💬 Note from Doctor Luo: Many of our body’s systems — the blood circulation, for instance — run themselves, independent of conscious control. I may want my heart to beat faster; it ignores me and keeps its own rhythm. These are the self-running systems — the autonomic nervous system. And these systems are especially vulnerable to emotion. When bad emotion turns severe, when the liver qi is constrained, qi and blood cannot flow freely and knot up — liver qi stagnation — it triggers severe systemic disorder, and the autonomic nervous system falls into chaos.

What happens when it falls into chaos? First, the cardiovascular system:

💬 Note from Doctor Luo: Severe bad emotion genuinely changes the cardiovascular system — chest pain, discomfort in the front of the chest. I have spoken with senior Western-medicine department heads about this, and they too believe that bad emotion plays a very large, even dominant, destructive role in the formation of cardiovascular disease. How does Chinese medicine explain it? The liver belongs to wood; when liver fire blazes — because the emotions are unwell — wood generates fire, and the fire grows and grows. The heart in the five-phase system belongs to fire; when wood and fire both burn, the heart fire burns beyond measure and the heart system collapses — we call this mu huo tong ming, wood feeding fire. Some people, in a single burst of rage — one fit of anger — the cardiovascular system fails and they are gone on the spot. So a great many chest pains, precordial discomforts, and oppressive feelings are tied to bad emotion. Especially in winter, when it is cold: some people already have blood stasis, stagnant blood in the heart channels; the cold makes everything contract — and then you explode in anger, the cardiovascular fire flares up, and snap — it ruptures. Danger. Everyone, remember: do not lose your temper in deep winter.

Second, the gastrointestinal system: the belching, acid reflux, and nausea mentioned earlier, plus a burning or churning feeling in the abdomen, bloating, constipation or diarrhea — this system is especially easily disturbed by emotion. In Chinese medicine the explanation is the liver wood running rampant and attacking the spleen earth: the spleen and stomach belong to earth, the liver belongs to wood, and wood can overcome earth — the liver qi bullies the spleen and stomach, producing all kinds of digestive disorder.

Third, the respiratory system:

💬 Note from Doctor Luo: The lungs belong to metal, the liver to wood. When the liver fire — the wood-fire — burns big enough, it melts the lung metal — we call it mu huo xing jin, wood-fire tormenting metal — and the respiratory system runs into trouble. We often speak of organic respiratory disease: someone who fumes for years, nursing grievances, develops lung cancer or interstitial lung disease — that is organic. But there is also a great deal of purely functional disturbance from bad emotion: patients tell me that at night, lying in bed — where they used to fall asleep without a thought — now the moment they lie down their breathing stops coming, they feel suffocated, they think they are dying and have to get up and go outside for air. And functional disturbance, left long enough, can turn into organic disease.

Fourth, the urogenital system — above all, female infertility:

💬 Note from Doctor Luo: Some women are so severely affected that they cannot conceive. I see that her liver qi is constrained; I soothe the liver qi, and she conceives almost at once — it really is emotion suppressing reproductive function. When reproduction is suppressed and disordered, pregnancy does not happen. Of the women who cannot conceive at an older age, I believe a very large share is tied to bad emotion: the older you get without a child, the greater the family pressure; the mother-in-law whispers daily, look, so-and-so has had a baby, and you are furious — but you genuinely cannot conceive. The more anxious, the more constrained the liver qi; the more constrained the liver qi, the more disordered the reproductive system; the more disordered, the less chance of conceiving. Then there are the families who adopt a child and — boom — the woman conceives right away. Why? Because once the child is adopted, the family mission is discharged: fine, we are not having one after all. The emotion unties at once, and she conceives naturally. There are a great many such people.

The Patient’s Trap: The More You Investigate, the More Anxious; the More Anxious, the More Illnesses

These symptoms, Doctor Luo Dalun says, are only examples — the problems seen in the clinic are far more numerous, more vivid, and more complicated than anything he can list here. And these patients share one common trap.

💬 Note from Doctor Luo: First, this illness is very hard to separate from organic disease: the patient keeps testing, nothing is found, so he concludes his disease must be hidden very deep — beyond the reach of today’s medical technology. And so he goes from hospital to hospital, testing for a very long time. And the more he tests, the more anxious he becomes; the more anxious, the more numerous the symptoms — how numerous? Sometimes he will hand you a whole page of a manuscript pad covered edge to edge with symptoms. Second, some doctors themselves do not recognize somatic disorders caused by psychological problems and never think to consider emotion. Add those two together, and these patients’ illnesses go unsolved for years — which is a great pity.

Why a pity? Because Chinese medicine is especially good at treating this kind of illness.

💬 Note from Doctor Luo: Emotion we call stagnant liver qi — liver qi constraint — because the liver cannot perform its duty of smoothing and dispersing the movement of qi and blood, so blockages form in the body, and those blockages of qi and blood produce all kinds of symptoms. Here Chinese medicine is genuinely skilled. If the illness is never resolved, the patient only suffers more and more — the intervention of Chinese medicine is very good and very effective.

Method One: Settle the Heart, Settle the Spirit

So how is it treated? Doctor Luo Dalun offers a three-level approach.

💬 Note from Doctor Luo: First, you must settle the patient’s heart and spirit. Most such patients are sunk in bad emotion and cannot pull themselves out. Sometimes the emotion is obvious; sometimes it is hidden — the person goes about his day looking perfectly normal, while deep in his unconscious a knot has formed. And there is a third kind, who have reached the point of scattered spirit-mind (xin shen san luan): they no longer trust their own body, no longer believe any doctor can cure them, and feel their illnesses multiplying. Every morning when they wake up they discover a new disease: the heart skipping, hands and legs swollen, a sudden pain in the belly, a sudden dizziness in the head. All day they watch their own symptoms, then pass the day in dread: it is over, something terrible has happened to me again. These people with scattered spirits are even harder to help.

So what to do?

💬 Note from Doctor Luo: Such people should find some form of spiritual practice or training — sitting meditation, standing post practice (zhan zhuang), chanting — to let the spirit slowly settle. I have found that a great many such patients simply cannot sit still: stay with them and you feel their perpetual dread; their bodies twitch and move; they scribble out questions and fire them at you, in the most scattered way. Their spirit has already scattered — they are afraid. At such times the task is to gather the spirit and still the qi, to trust the body, to trust the restorative power that nature has given you. This settling process is slow. Also, listen to the Dao De Jing, listen to the classics of Chinese learning — I lecture on the Dao De Jing myself — and many friends tell me afterward: I have seen through it now. I used to be petty and calculating, but now I have let it go; I just do my work with an open heart, and my mind feels sunny. Settling the heart comes first.

Method Two: Dredge the Channels

Second, dredge the channels.

💬 Note from Doctor Luo: Liver qi constraint, put simply, means emotion has knotted the movement of qi and blood into disorder, even stagnation — blockages form in certain places. The liver governs smoothing and dispersing, yet here even the liver cannot open things up. And because different emotions appear at different times, the stagnation lands in different places and different channels of the body, clotting at key points. For these knots, either ask a Chinese-medicine teacher to help open them, or learn some tapping and massage methods yourself, and gradually work them loose — opening these knots is very good for the whole body’s recovery.

At the same time, move more:

💬 Note from Doctor Luo: Most people with this kind of constraint do not like exercise, or else do a single repetitive exercise — always the same motion — and the body’s knots never come undone. Ball games are different. In a game, to save a ball you have to move in every direction, stretching and extending in all sorts of ways: twist left, then recover; these movements help open the channels. Notice that people who play badminton, football, or basketball in their spare time rarely have these problems — they are comparatively freer and smoother.

Method Three: Herbal Formulas

Third, herbal formulas.

💬 Note from Doctor Luo: When the liver qi is constrained, we use the Chinese-medicine methods of soothing and regulating the liver qi. I have lectured on so many formulas: those that soothe the liver, those that drain fire, those that open the channels. We use dispersing methods, formulas that resolve liver constraint and move the qi, to untie the blood stasis; if there is blood stasis, we invigorate the blood and transform stasis; if yang qi is deficient, we warm the yang — warming yang to transform stasis and untie constraint. When these knots are loosened by herbal methods, the body’s problems are correspondingly resolved.

Closing: Illnesses from Bad Emotion Are Like an Iceberg

Doctor Luo Dalun closes with a sigh: the physical problems caused by stagnant liver qi and bad emotion — some of them you truly could never imagine. Bring a case to the table and it is simply astonishing.

💬 Note from Doctor Luo: The mild end is all the vague discomforts of daily life — why do I feel like this? I cannot find a reason. It may well be tied to bad emotion. The illness caused by bad emotion is like an iceberg: the part above the water is only a small tip, and beneath it sits an enormous mountain of ice, whose danger we have not yet fully recognized. Western psychology has done a great deal of research here, and Chinese medicine has its own summaries — in the end both traditions walk the same road, analyzing the same problem. But because our ancient ancestors were so brilliant, Chinese medicine long ago devised many solutions, and they are genuinely effective. Sometimes you send a patient to a psychologist and he will not believe a word: with an illness this serious, how could that be? But then Chinese medicine is applied, the symptoms vanish, and he says: see — it is cured. So Chinese medicine is a very effective way of regulating this.

Today’s talk is meant mainly to make everyone take this seriously: once you know the harm of bad emotion, keep your distance from it, be happy, and do not let yourself fall into a state of illness because of it. Next time we will talk about more ways to regulate the body.

What to Take Away

• Bad emotion causes real, severe bodily symptoms. Western medicine calls it somatic symptom disorder; Chinese medicine calls it stagnant liver qi (gan qi bu shu). The two traditions are describing the same thing.
• Five common families of symptoms to watch for: unexplained pain (headache, abdominal pain — the gut brain — joint pain); gastrointestinal complaints (reflux, chronic pharyngitis from rising stomach acid, constipation, diarrhea); urogenital complaints (menstrual changes, sexual dysfunction — far more often emotional than kidney deficiency); pseudo-neurological symptoms (paralysis, plum-pit qi, sudden blindness or deafness, strange skin sensations); and cardiorespiratory complaints (chest tightness, shortness of breath, a sense of impending death).
• In the heavier cases the autonomic nervous system itself goes wrong: wood-fire injuring the heart and blood vessels (never lose your temper in deep winter), liver overacting on the spleen and stomach, wood-fire tormenting metal in the lungs, and liver constraint suppressing female fertility.
• If your symptoms keep shifting and no organic cause can be found, consider emotion first. Patients who run from hospital to hospital only grow more anxious — and the more anxious, the more numerous the symptoms.
• Three ways to regulate: settle the heart and spirit (meditation, standing post practice, chanting, listening to the Dao De Jing); dredge the channels and move the body (ball games that stretch you in every direction); and herbal formulas that soothe the liver and regulate qi. Chinese medicine is genuinely effective at untangling what emotion has knotted up.

Compiled from Doctor Luo Dalun’s health lecture series (Emotions and the Body: Somatic Symptom Disorder).