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Table of Contents
Year : 2023  |  Volume : 9  |  Issue : 3  |  Page : 330-337

The psychosomatic thought of tibetan medicine and its treatment methods

1 School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
2 School of Traditional Chinese Medicine; Institute of National Medicine, Beijing University of Chinese Medicine, Beijing, China
3 School of Tibetan Medicine, Qinghai University, Xining, China

Date of Submission15-Dec-2021
Date of Acceptance28-Apr-2022
Date of Web Publication05-Apr-2023

Correspondence Address:
Dr. Hui-Hui Zhao
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing; Institute of National Medicine, Beijing University of Chinese Medicine, Beijing
Dr. Xiao-Qiao Ren
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing; Institute of National Medicine, Beijing University of Chinese Medicine, Beijing
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2311-8571.373598

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Objectives: Call on people to treat the causes of physical diseases is to take into account the causes of psychological factors as well as external causes. Materials and Methods: The analysis was conducted by combining the classical medical books of Tibetan medicine, as well as the traditional culture and living habits of Tibetan people, with modern research results. Results: Many of the theories mentioned in Tibetan medicine related to mind-body medicine have been confirmed by modern research. Mental and physical treatment related to psychosomatic diseases should be administered simultaneously. First, when a person is healthy, he should cultivate his mind to build a solid psychological defense against diseases. Developing both the mind and body contributes to creating a stable physical protection barrier against diseases. When a person is ill, he should realign his mind and help his body adjust and promote its early recovery with the help of medications. Conclusions: Treating related psychosomatic diseases should treat the mind and body simultaneously. And the mind and body should be cultivated before diseases to reinforce the psychological and physical defense against diseases.

Keywords: Knowledge, psychosomatic medicine, Tibetan medicine, treatment methods

How to cite this article:
Zhang ZJ, Li X, Cheng YX, Jorigori A, Renqing D, Pan LP, Mao M, Ren XQ, Zhao HH. The psychosomatic thought of tibetan medicine and its treatment methods. World J Tradit Chin Med 2023;9:330-7

How to cite this URL:
Zhang ZJ, Li X, Cheng YX, Jorigori A, Renqing D, Pan LP, Mao M, Ren XQ, Zhao HH. The psychosomatic thought of tibetan medicine and its treatment methods. World J Tradit Chin Med [serial online] 2023 [cited 2023 Sep 25];9:330-7. Available from: https://www.wjtcm.net/text.asp?2023/9/3/330/373598

  Introduction Top

With the transformation of modern medicine from the traditional medical model to a social-psychological-biomedical model, psychosomatic medicine gradually emerged. In 1944, the Psychosomatic Medicine Association was founded in the United States. There are six International Academic Organizations of Psychosomatic Medicine globally, and there are five local organizations in China. These medical academic organizations highlight that psychosomatic medicine research has entered a relatively mature stage. In China, traditional Tibetan medicine comprises many psychosomatic medical concepts, which have continuously served as a sound guide in treating modern psychosomatic diseases.

Psychosomatic medicine and psychosomatic diseases

Psychosomatic medicine, also known as psychophysiological medicine, is a unique field of research.[1] A German scholar, Felix Deatsch, first introduced the term “psychosomatic” in 1922. In 1935, an American psychiatrist, Dunbar F. Dunbar, attributed certain diseases to specific personality factors in his book Emotions and Bodily Changes. In 1939, he then founded the Journal of Psychosomatic Medicine. Since then, psychosomatic medicine has been established as an independent academic status. Psychosomatic medicine comprehensively uses the methods of biology, psychology, and social science to explore the significance of mental and social processes for the generation, maintenance, outcome, and treatment of physical diseases.[1] Psychosomatic medicine can be defined in terms of a broad or narrow sense. In the broad sense, psychosomatic medicine refers to the study of the relationship between mind and body, the interaction of physiological factors, psychological factors, and social factors, and the impact of these factors on the occurrence and development of diseases and human health. In the narrow sense, psychosomatic medicine refers to the study of the etiology, pathology, diagnosis, treatment, and prevention of psychosomatic diseases. For example, it illustrates the relationship between these aforementioned factors and disease processes, such as psychological tension, excessive emotional fluctuation, and personality characteristics. Moreover, the object of the research is only psychosomatic diseases. Psychosomatic diseases, also known as mental disorders, are not merely psychoses or neuroses, but a series of diseases closely related to psychological and social factors whose clinical manifestations are mainly physical symptoms. The pathological changes of these diseases are often limited to the dysfunction of organs or systems dominated by the autonomic nervous system and somatic diseases related to social tension and stimulation, genetic quality, personality characteristics, and emotions.[2] It can be clinically manifested as psychosomatic reactions, psychosomatic symptom disorders, psychosomatic diseases, psychological factors related to physical conditions (such as eating disorders, sleep disorders, or sexual dysfunction), and physical diseases (such as tumors, diabetes, hyperthyroidism, hypertension, ulcerative colitis, eczema, gastroduodenal ulcer, bronchial asthma, or neurodermatitis) complicated by psychosomatic symptoms. These diseases have gradually replaced previous infectious diseases and seriously endanger human health.[3] Neuropsychiatric diseases include mood disorders (such as depression), anxiety disorders, mental disorders caused by psychoactive substances (such as heroin addiction), impulse control disorders, personality disorders, hysteria, schizophrenia, and more. The onset of psychosomatic diseases, neurosis, and certain mental diseases are related to psychological factors. However, psychosomatic diseases manifest as apparent physical symptoms, mainly anxiety, depression, insomnia, pain, and somatization symptoms. One or several symptoms, the symptom is not based on a confirmed organic disease. Although each patient has a specific disease diagnosis, the severity of the disease does not always correspond with the patient's symptoms. The patient may especially feel pain, powerlessness, and a lack of self-awareness, which are unique features of psychosomatic diseases, while neurosis and mental diseases have no organic pathology, but only denote dysfunction.[4]

Psychosomatic medicine in Tibetan medicine

Tibetan medicine is an indispensable part of traditional Chinese medicine (TCM). The ideological framework and clinical practice of Tibetan medicine are based on the psychological world of patients and doctors at their core, but are focused on the body for clinical treatment. Therefore, some experts believe that: “Rather than saying that Tibetan medicine is a kind of therapeutic medicine that focuses on treating physical diseases, it is better to say that it is a life medicine based on the mind, treating and preventing mental and psychosomatic diseases.”[5],[6]

Tibetan medicine's understanding of mental organs

Tibetan medicine proposes that people have five realms and six senses (eye awareness, ear awareness, nose awareness, tongue awareness, body awareness, and consciousness). With these senses, people can perceive objective things from the external world and subsequently, generate consciousness and start thinking. Reflections from the consciousness can bridge the connection between the heart and brain. Therefore, it is believed that the brain is a projected organ of the mind; the Four Medical Tantras, mention that “the brain is the sea of white channels, the main residence of Béken, and the place where rLung and blood runs.” “The trunk of the white channels extends from the brain down to the spinal cord. From this trunk, numerous branches are leading to the trunk and limbs, like an inverted tree.” That is to say, the brain uses the white channels distributed throughout the body to interpret external senses. It emphasizes the functions of the “six senses” and internal “seven emotions.” Therefore, the brain is an organ that manages thoughts and emotions.

Concurrently, Tibetan medicine and TCM also believes that people's mental activities cannot be separated from the heart's function. The Four Medical Tantras states that: Those “with the clear mind reside in the heart, and there are five hundred fine channels around it;” and that “the heart is like a lotus flower, with a horsetail filamentous channels king,” with Avadudi in the center (the Tibetan name, “Yi Sang Ma,” which means holding the emotional channels). There are six hollow branch channels around, above, and below the pericardium. The color of the east channels is black, which controls hearing; the color of the south channel is red, which controls vision on the right side; the color of the west channel is yellow, and its back controls smell; the color of the north channel is white, and its left side controls taste. The green channel is green, which governs the body's sense of touch; and the color of the channels below it is also green, which regulates consciousness and is responsible for consciousness circulation. “The heart is the king of the viscera and the place where life and mind depend.” The heart is considered the king of the body's viscera and organs. The heart is the primary organ responsible for mental activities. Moreover, the heart is the residence of the pervasive rLung, which walks all over the body. Pervasive rLung can regulate whether the mental activity of the heart is regular or not. The heart beats rhythmically, which continuously transports rLung and blood to all body parts, nourishing and moisturizing the body. The heart is also the home of one of the seven essences, which allows people to produce energy and consciousness. The dwelling place of the accomplishing Tripa makes the heart possess its consciousness in a good state; additionally, it is in charge of the boldness, master strategy, arrogance, desire, and management of human life and thinking. Tibetan medicine also points out that the human heart is closely related to emotions. For example, the common causes of heart disease include grief, overthinking, anger, unpleasant remarks, panic, and so on. These statements all show that the heart is the organ of chief consciousness and functions to control people's mental activities. It is one of the mental organs, which is very different from what modern medicine describes it to be.[6]

Tibetan medicine's understanding of the etiology and pathogenesis of psychosomatic diseases

Tibetan medicine emphasizes the idea of the “harmony between human and nature” and “interaction between human and nature.” The five elemental dynamics are the essential substances that constitute the world of devices (space, earth, and everything) and the world of feeling (human and living things), so both space and earth are closely related to the human body, and their changes will subsequently affect human health; The Three Causal Factors of the human body's growth, rLung, Tripa, Béken, and the seven essences (including diet, blood, muscle, fat, bone, marrow, and semen) are in a state of dynamic balance and coordination to maintain normal day-to-day activities of the human body.[7] When adverse factors break the state of balance, it will lead to various diseases. Tibetan medicine divides the factors that lead to the occurrence of diseases into two aspects: external factors and internal factors. External factors are also called outside causes, or auxiliary causes, which mainly refer to the seasonal climate (such as wind, cold, summer heat, dampness, dryness, or fire), overeating, abnormal behavior, daily life, feeling the foulness of the epidemic, poisoning, sword and beast injuries, and bruises. They all belong to external factors. These factors need to work through the internal factors. Hence, the chapter on external causes of disease in the Four Medical Tantras states that common external factors include seasons, sneakiness, abnormal diet, abnormal daily life, poison, a doctor's misdiagnosis, and a drug reaction. These factors can cause diseases in the human body. It is also worth thinking about the exact external factors (outer circumstances) that cause disease. Why do some people get sick, while others do not? Tibetan medicine believes that this is mainly because of the Three Causal Factors of the body, which are in a state of balance under normal circumstances. The body has a solid ability to resist disease, and even an external cause, cannot cause illness on its own. Illness occurs when the balance between the Three Causal Factors is broken, and the balance is lost. Once inciting factors, such as seasonal climate, nutrition, work and rest, and the bias of the five aggregates appear, it can lead to the imbalance of the seven significant substances in the body, thus destroying the balance of the Three Causal Factors. This can then lead to a disease state. In other words, Tibetan medicine is rooted in the belief that the external causes of disease can only be inciting or contributory factors that lead to infection or disease; however, it is the “internal causes” that play a more critical role in the development of disease.

The “internal causes” in Tibetan medicine refer to inherent pathogenic factors in the human body, namely Three Causal Factors of rLung, Tripa, and Béken, also called “pathogenic factors,” which are further divided into remote internal factors and near internal factors. The remote internal factors involve ignorance.” The resulting “greed, hatred, and delusion.” are part of the subconscious of human beings (such as possessiveness, hedonic thoughts, or lazy emotions.), and these are three types of poison that ultimately lead to diseases. Excessive, insufficient, and disturbed under various factors eventually become potential factors that harm the human body and negatively affect the “three evils” or “pathogens,” which are the near internal factors of diseases.

From the perspective of pathogenesis, Tibetan medicine emphasizes the importance of people's internal psychological factors in causing disease. This is mainly because Tibetan medicine believes that there is a close connection between people's psychological activities and physical functions. The reaction caused by this kind of stimulus is the root cause that affects human health and disease. A good mental state allows an individual's physiological function to reach its optimal condition. Modern science further proves that emotions influence the whole body's psychological and physical activities through the brain. Whenever a person feels comfortable and happy, his central nervous system is in its best functional state. The human internal organs and endocrine activities are balanced and regulated under the central nervous system. During this time, respiration, blood pressure, and metabolism are more balanced and coordinated; and they adapt to the environment more effectively. The whole body is well coordinated and full of vitality, and the body is naturally healthy. At the same time, a good mentality and consciousness can promote the secretion of higher amounts of acetylcholine and hormones and enzymes, which are beneficial to the body. These substances adjust the blood flow and nerve cell conduction to their best states, thereby enhancing the body's disease resistance and anticancer ability, thus promoting good health and longevity. On the other hand, it can reduce or destroy the physiological functions of the human body, thereby negatively affecting human health, and thus, becoming susceptible to the occurrence of diseases. For example, modern research has found that many diseases are related to nervous emotions. For example, the long-term bad mood will cause dysfunction in various organs, lower immunity in the body, and therefore, predispose the body to illness. Myocardial infarction, cerebral hemorrhage, high blood pressure, angina pectoris, gastric and duodenal ulcer bleeding, diabetes, asthma, migraine, and hyperthyroidism can all be triggered by excessive nervousness. Tension, anxiety, and anger cause the heart to beat faster, blood pressure to rise, vessels to spasm, blood cholesterol levels to increase, arteriosclerosis to worsen, and the overall incidence of cardiovascular and cerebrovascular diseases to increase. The incidence of gastrointestinal diseases due to dysfunctional biochemical regulation process has also increased. As early as in the classification of the causes and symptoms of diseases in the Four Medical Treatises, it was pointed out that people's emotional changes include: “attachment, aversion (jealousy, resentment), delusion, sadness, anxiety, reticence, panic, unhappy mood;” additionally, they “often appear haggard, restless, and irritable.” It has also been said that if the spleen and stomach are injured, and a person's mood becomes depressed or is easily stimulated, and then his behavior becomes abnormal. The once pleasant character disappears, and now, the temper becomes irritable; during this time, it can be said that the person is not far from death. This means that if a person's spirit is in a state of depression, melancholy, or panic for a long time, his physical and mental health will consequently be destroyed, The Four Medical Treatises, it was pointed out that people's emotional changes include: “attachment, aversion (jealousy, resentment), delusion, sadness, anxiety, reticence, panic, unhappy mood;” additionally, they “often appear haggard, restless, and irritable.” It has also been said that if the spleen and stomach are injured, and a person's mood becomes depressed or is easily stimulated, and then his behavior becomes abnormal. The once pleasant character disappears, and now, the temper becomes irritable; during this time, it can be said that the person is not far from death. This means that if a person's spirit is in a state of depression, melancholy, or panic for a long time, his physical and mental health will consequently be destroyed, leading to various diseases.

The Four Medical Tantras mention that the internal cause of rLung's disease comes from ignorance and greed. The external cause is disappointment, grief, excessive thinking, sorrow and depression, noise, and long-term consumption of nonnutritive products. In addition, more rLung evil was allowed to accumulate and prosper in his position and then, it was allowed to encounter more external causes. Internal psychological factors such as greed, worry, depression, and sorrow are important causes of rLung disease, Tripa disease, and Béken disease; these are also inseparable from the influence of internal psychological factors. For example, disappointment, crying, sadness, depression, and excessive thinking can lead to rLung disease; anger and panic can lead to Tripa disease; finally, worrying and stupidity can lead to Béken sickness. Additionally, sadness and a hardened heart can cause indigestion. The Four Medical Tantras also states that the cause of people's illness or premature aging can be caused by the excessive activity of the five sense organs and bad habits. In addition, it further points out that “worry and sadness induces aging in the face, panic, cowardice, and unhappiness; these make people look very decadent,” and can be manifested as irritable temper and weird or suspicious behavior. It is easy to cause harm to the mind and body, which results in backache, stomach pain, insomnia, neurasthenia, etc. Modern medical research also shows that a person's mental state can affect the immune system. The mental condition, whether good or bad, and confidence in overcoming the disease directly affect the overall prognosis and survival of cancer patients. Due to the great emotional impact, a bad mood stimulates the brain to produce biochemical effects, causing a chain reaction of cancer cell proliferation, a weakened immunity against cancer, and an increasing cancer incidence. The findings are highly consistent, indicating that Tibetan medicine already contains the knowledge of the “social-psychological-biomedical model” of diseases; this is inconsistent with the academic view of “the body is a whole corresponding to the physical and psychological holographic” put forward by some scholars in recent years.[5] The structure diagram of the etiology and pathogenesis of Tibetan medicine is shown in [Figure 1]
Figure 1: Etiology and pathogenesis of Tibetan medicine

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Tibetan medicine's prevention and treatment of psychosomatic diseases

Simultaneous treatment of the mind and body – the principle of Tibetan medicine in treating psychosomatic diseases

Although psychosomatic diseases and general physical diseases have physical symptoms, the difference is that the occurrence, development, and outcome of psychosomatic diseases are closely related to psychological factors. General physical diseases do not have this feature. Therefore, the treatment of psychosomatic diseases using Tibetan medicine emphasizes the simultaneous treatment of the mind and body, interprets psychological problems based on physical symptoms, and treats physical and mental diseases through the active behavior of the self and the method of simultaneous treatment of the self's mind and body by the object. The substantial body and the intangible psychology are integrated, and the pathological changes and psychology of the human body are integrated, too. The coordination of responses is adjusted to promote the restoration of balance and coordination between the human body, the external environment, and the internal psychological environment of the body, and restore the Three Causal Factors of the human body to a balanced state. This is the basis for Tibetan medicine to treat psychosomatic diseases.

Tibetan medicine emphasizes that the object of medical treatment is humans, not just living organisms. It has natural attributes and needs the nourishment of diet in material life. People also possess social attributes, more complex psychological activities, and emotional adjustments in spiritual life that are indispensable. The suppressed and hidden emotions in daily life will be recorded and stored in our bodies. When people use their bodies to express psychological problems, they usually present with psychological depression, which manifests as suspiciousness, fear, anxiety, anxiety, depression, and mania. Once it seems to digest their emotions by damaging their body's organs, such as the digestive, nervous, endocrine, and reproductive systems, and the skin, are the hardest hit regions. Various people show symptoms such as physical pain and skin diseases. For example, some scholars believe that mentally induced vitiligo is a substance in the central nervous system, mainly the pineal gland, which inhibits melanin formation-melatonin. Under normal circumstances, it is in dynamic equilibrium with the melanin secreted by the pituitary gland.

When there is too much melatonin, it can inhibit the formation of melanin. When people's spirits are viciously stimulated, or their emotions are highly stressed and over-suppressed, melatonin will increase, leading to vitiligo. At the onset, or when they are getting better, some patients experience an enlarging leukoplakia that may develop due to mental overstimulation, tension, or depression. Expanding, growing, or developing vitiligo requires physical and mental treatment.[8] Another example is from Professor Yi Zhang, who advocates the treatment of psoriasis: “When treating physical diseases, do not forget to treat the inner psychological impact. When treating mental diseases, do not forget to treat physical problems.” Psychological counseling and physical and mental treatment can enhance curative effects.[9] Therefore, treating these diseases may not solve the fundamental problem if we only rely on drug treatment. Curing the disease can be achieved by treating the disease both physically and mentally.

The methods of Tibetan medicine to treat psychosomatic diseases

The purpose of understanding the disease is to treat the disease more effectively. In the treatment of some psychosomatic diseases, dialectical therapy is required based on the state of the disease.

  Cultivating the mind and nature – building a psychological defense against diseases Top

Mental recuperation, also called psychological recuperation, is one of the crucial methods of health preservation and longevity in ancient Tibet. Tibetan medicine believes that human beings are in space and earth and that human mentality has an invaluable effect on the overall function of the human body. Diet, daily living, medicine, and device treatment are Tibetan medicine. There are four effective therapies for treating diseases, but regulating emotions and moral cultivation is the first step toward controlling the overall situation. Particular emphasis is placed on nourishing the mind, spirit, nature, and morality while focusing on regulating emotions and cultivating sentiments. The Four Medical Tantras also guide people's daily behavior; some believe that it is necessary to be kind to others, speak with warmth, and be considerate of others. Some manifestations of this include: thinking carefully before speaking, controlling one's words, and not saying things that should not be said. In dealing with people, we should be considerate and loving toward subordinates, be polite to our elders and teachers, be united with the elders and fellow villagers, and uphold justice. Even if you are very knowledgeable, you must remain humble. The rich must learn to be content; they must not bully the good and fear evil, they must not be greedy for petty gains, they must reflect on what is wrong in time, with justice on their mind. Additionally, they must be broad-minded, righteous, and open-minded. He also clearly pointed out: “emotional Tripa is located in the heart, broad-minded and proud to do what he wants to do.” He also said: “enough wisdom, open-minded, and kind, keep your vows in mind when dealing with others, behave properly, friendly attitude, and be conscientious, ethical, and virtuous in your work;” “ restrain your anger and maintain a kind-hearted nature;” “integrity, fairness, generosity, compassion harmony, benevolence to the poor, knowing gratitude and repaying, not flattering the powerful, and not bullying inferior people.” Only in this way can the Three Causal Factors be balanced, evil can be prevented from destroying genuinely, gain health, and prolong life. Additionally, he mentioned that having no major changes, an open mind, and a beautiful and radiant appearance is a sign of good health. On the contrary, it is the time of death. Sun Simiao also said, “moral behavior is not restricted, even if it is taken with good food, it may not be able to live rLung.” This means that one must adjust one's emotions and make one's mood peaceful to ensure that the seven emotions are not damaged, the five yin organs and the six yang organs will be harmonized, and there is no opportunity for the six evils to thrive. Only by avoiding all diseases can one live a long life.

The foreign longevity scholar, Hu Fland, pointed out in the Law of Human Growth and Life: “Of all the unfavorable factors, there is no one that can make a person short-lived more than bad emotions and bad moods, such as worry, depression, fear, covetousness, cowardice, jealousy, hatred.” These views have been proved by modern scientific research. For example, a longevity survey found that the vast majority of the elderly have a good mood, are optimistic, calm, kind, cheerful and robust, and rarely lose their temper. Therefore, academician Wang Yongyan also proposed “to enable individuals to transform “ignorance” into “enlightenment” through meditation and realize the principle to achieve the unity of mind between the individual and the universe.”[10] Modern psychological research shows that when a person is in a good mood and happy consciousness, the central nervous system is in its best functional state. Then, the person's internal organs and endocrine activities are also in a balanced state, since they are under the regulation of the central nervous system so that the whole body is coordinated and full of vitality. The body is naturally healthy.[11] Because good psychology and consciousness can promote the body to secrete more beneficial hormones, enzymes, and acetylcholine, these substances can adjust the blood flow and the excitation of nerve cells to the best state, thereby enhancing the body's resistance to disease and cancer, which contribute to the promotion of human health and longevity. As the economy becomes more developed, the side effects such as fast-paced life, high work pressure, and fierce social competition will increase, and the resulting physical and mental illnesses will increase. For example, foreign sample surveys show that 35% of diseases are related to emotional stress. The survey also shows that optimistic, humble, and proactive people are much healthier than those who are arrogant or pessimistic. Because they are in a dark mood or are overcome with nervousness and impulsivity, their body's resistance weakens, their immune function deteriorates, and ultimately, these will lead to many diseases, such as ulcers, cardiovascular and cerebrovascular diseases, high blood pressure, cancer, and premature aging. These diseases are closely related to patients' emotional imbalances. Given this, to improve the health of the whole human population, it is necessary to actively use inexpensive ingredients in the practice of Tibetan traditional medicine. It is necessary to popularize the common sense of daily health care to the whole world and guide the public to consciously strengthen the cultivation of their character, and at the same time, achieve the goals of promoting a sound mental and physical health, and longevity.

In a mood and health correlations study, suppressing emotion-related cardiovascular responses, such as a fast heartbeat, was approximately twice as effective as expressing emotion-related reactions. The group with high levels of anger showed significantly more cardiovascular symptoms, which continued to increase at the fastest rate during the last two measurement periods.[12] A meta-analysis also found that 24% of cancer patients were diagnosed with major depressive disorder. The impact of life stressors has also been studied within the context of the human immunodeficiency virus (HIV) spectrum disease. Leserman et al. followed men with HIV for 7.5 years. They found that faster progression to acquired immunodeficiency syndrome was associated with a higher cumulative number of stressful life events, the use of denial as a coping mechanism, lower satisfaction with social support, and elevated serum cortisol.[13],[14]

  Both mind and body – build a strong line of defense against disease Top

Health preservation and longevity are the goals of Tibetan medicine for psychosomatic medicine. In mind-body medicine, Tibetan medicine has permanently attached great importance to maintaining the consciousness, the external physical beauty, and internal spiritual awareness of health and beauty. Tibetan medicine is the medical knowledge accumulated from the cognition process of introspection: the introspection of nature and self. Tibetan medicine regards the two essential elements of the world, namely, humans and nature. This emphasizes “the unity of man and nature” and “the unity of body and mind;” it makes full use of the characteristics of human beings as the spirit of all things, emphasizing consciousness is exercised in training. Through the active use of consciousness, external mechanical movements, and internal consciousness activities are emphasized, it is important to know that “the unity of body and consciousness” guarantees health. The development of the body and the mind should be coordinated. People should have a good mental state and conscious activity; good emotions are conducive to physical and mental health and well-being. The body is in harmony with the consciousness so that the body's internal and external parts can be well exercised, strengthening the external shape and inner viscera, and the overall function of spiritual consciousness. For example, the “Daily Behavior” of the Four Medical Tantras instructs: “Try to prevent bad things from appearing and make them manifest when good signs appear. Please observe before doing things. Doing things well is a good deed. Even if you say a lot, if it is unfounded, please consider it from the perspective of good faith. When speaking, please first consider whether your behavior is appropriate” The ten evils need to be removed from the body, speech, and mind. To defeat nonrighteous victory, there is a sense of measure. If you are learned, humble, and rich, you must be content. Always be compassionate and virtuous and bodhicitta. Additionally, to “have a righteous mind and a broad mind” is important. This is the same as the view that the ancients emphasized that a gentleman should “continue to strive for self-improvement.” Otherwise, “laziness of the mind will lead to the laziness of the whole body.” Tibetan medicine's view of nature and life also lies in health and rehabilitation sports. This is particularly evident in its activities, which can be seen everywhere in Tibetan traditional Tibetan Qigong, Tibetan dance, Zhuang linkuo, national sports, and health preservation activities. It emphasizes the unity of humans and nature and the unity of human psychology and physiology. Thus, establishing a health-preserving sports system that integrates the dual cultivation of life and the simultaneous cultivation of mind and body is crucial.[15]

Tibetans also have a wealth of sports to materialize the concept of health preservation, advocated by Tibetan medicine. For example, Tibetans hold many horse races every year, including Nagqu Horse Racing Festival, Damxung Horse Racing Club, and Qiangtang Horse Racing Club. Although the horse racing festivals in Tibet vary in size, time, and duration, the activities are rich in experience. Not only are these events limited to horse racing, but other sports as well, including archery, tug-of-war, song and dance performances, Guozhuang evening parties, and other entertainment activities.[16] In a 2020 survey report, it was pointed out that national fitness had become the favorite way of life for people of all ethnic groups in Tibet. There are nearly 8000 sports venues in Tibet, with a sports venue area of about 4.9 million square meters and a per capita sports venue of 1.42 m2; 29.6% of the population regularly participate in physical exercise.[7]

At present, psychosomatic medicine believes that people's bodily diseases or long-term stress and pain are mostly related to human body postures, emotions, internal belief systems, and exercise methods. To bring the body back to a healthy, balanced, and free state, massage and conscious self-rhythm can be used to bring the body's fascia, muscles, and joints back to a harmonious state. Additionally, the use of function-oriented limb therapy, that is, the slow guide through movements, gradually replacing the old model with a more efficient new model, eliminating excessive muscle tension in the body, distributing the whole body's weight evenly, relieving the muscles and joints, and making the movement smooth and unobstructed. In this way, the extensors and flexors can find the best balance, and the purpose of relieving or treating pain in specific parts of the body can be achieved. The psychosomatic treatment method of Tibetan medicine has the same clinical medical value as this. In addition, Qigong, Tai Chi, Dao Yin, meditation, Baduanjin, and other health-preserving methods are also critical health-preserving tools for both the body and mind.[17] Their clinical curative effects are recognized. For example, the guiding technique can balance yin and yang, harmonize the qi and blood, dredge the meridians, cultivate vitality, strengthen the muscles and bones, improve the disease of desire and treat the disease of disease, and also have a specific effect on the exercise of the sick disease through the guiding technique.[18]

  Regulate emotions and assist drugs in regulating the body – promote the body's speedy recovery Top

It has been clinically verified that food nutrition and health care can promote the speedy recovery of patients. However, the human mind also needs adequate nutrition. An unhealthy mind can affect people's health and ultimately, cause the aggravation of the disease or somehow affect the recovery process of the patient. Nowadays, the incidence of psychosomatic diseases in the cardiovascular, cerebrovascular, endocrine, digestive, mental, and nervous systems has risen sharply, and this is attributed to people's mental health. At the same time, we recognize that many patients have various psychological problems. Psychotherapy is needed during treatment, and it has also been discussed in Tibetan medicine. For example, the Secret Department of The Four Medical Tantras pointed out: “Treatment of Xingyao Disease (Stroke): Put people in jail, smoke medicine, immerse in water, chant mantras, apply the medicine, massage, pour cold water on the body, blow snails behind the ears, and scream for killing the disease.” This psychotherapy can unblock the pathway of consciousness and balance the Three Causal Factors function for people who believe in Buddhist things and has an unexpected effect on the treatment of diseases. Tibetan medicine recommends that people with psychological problems caused by illnesses should take medication as the primary treatment so that patients can fully understand that the efficacy of the prescription itself has a significant effect on the cure of diseases and increase confidence in the therapy of the disease via prescription. The names of some Tibetan medicines have psychological implications, such as Anshen Pills, Shusheng Powder, and Pearl Pills, which make patients who do not understand medicine feel that these medicines have magical and powerful effects. Hence, they are more willing to accept the treatment with these medicines. For example, the palpitation caused by panic can be treated with the Tibetan medicine Anshen Pill. It is composed of stick hammer, rabbit heart, bison heart, asafoetida, and brown sugar. Not only does the name of the prescription have a psychological effect, but also the composition of the medicine in the prescription also has a psychological effect. These drugs have products that regulate rLung and emotion. Therefore, Tibetan medicine uses the product to treat conditions including neurasthenia, wind into the lifeline, neurosis, delirium, dreaminess, tinnitus, heart palpitations and trembling, and madness. These kinds of prescriptions that help improve the curative effect of drugs with the help of emotion adjustment are everywhere.[19]

This concept of prevention and treatment is widely used in TCM. For example, some scholars provide specific rehabilitation guidance in different recovery periods of stroke patients, combined with the actual condition, including active and passive exercise, from easy to difficult, step by step, to improve the blood circulation of patients and promote recovery from hemiplegia. It stimulates a good blood supply to the limbs, repairs skeletal muscle tissue, improves body resistance, reduces the formation of venous thrombosis and muscle atrophy in the lower extremities, promotes the recovery of nerve function in patients, improves their quality of life, and has apparent curative effects.[20],[21]

  Conclusion Top

Tibetan medicine contains vast psychosomatic medical knowledge. It is believed that the occurrence of diseases is a problem with physical health and mental health. The human body and the mind are unified, and the external factors trigger the diseases. Internal factors are the crucial factors that lead to the disease. Therefore, treating related psychosomatic diseases should treat the mind and body simultaneously. First, the mind and body should be cultivated before diseases to reinforce the psychological and physical defense against diseases. When you are sick, you can adjust the heart to improve the efficacy of the medicine and adjust the body to promote the body's speedy recovery.[22]

Financial support and sponsorship

This work was supported by (1) The National Natural Science Foundation of China (81774448), project leader: Ren Xiaoqiao; (2)The key research and development and transformation project of Qinghai Provincial Department of Science and Technology, the study on the mechanism of action and clinical efficacy evaluation of Tibetan medicine Shiwei Weiming capsule in the treatment of “Sorong disease”, No. 2021-SF-C21;(3) The National Natural Science Foundation of China (81973697), project leader: Zhao Huihui.

Conflicts of interest

There are no conflicts of interest.

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