LIBBY HORESH: acupuncture and Chinese medicine
“THE PHYSICIAN HEALS, NATURE MAKES WELL”
There has been a growing trend towards finding balance and wellness within our lives. Yoga, mindfulness and meditation, are making headlines lately. However, at the same time, a recent study showed that nearly 60% of Americans are taking prescription drugs (source). It is an interesting conundrum, isn’t it? With all the side effects of drugs, have you ever wondered if there are alternative ways to heal before resorting to them?
Acupuncture is an ancient healing art. I tried it years ago. I didn't know precisely how acupuncture worked, but I enjoyed the peace and serenity I felt during the session and I definitely gave it some credit for making me feel better overall. Fast-forward 5 years…a dear friend recommends her acupuncturist to help me with some issues I was experiencing. Always willing to try new things, I eagerly make an appointment with Libby Horesh, board certified in acupuncture and Chinese medicine.
When I am experiencing an ailment, I prefer to get to the root cause instead of simply putting a “band aid” on it. Acupuncture attempts to get to the root cause of your illness. We all know someone who is living in pain – back pain, neck pain, joint pain. Recently the CDC reported that Americans are living longer, however, the prevalence of pain is increasing (source). Over the years, opioids have routinely been prescribed to help with pain. In 2016, the American Society of Addiction Medicine reported that there were 20,101 overdose deaths from prescription pain medicines in 2015 (source). As our country is increasingly becoming aware of these trends, acupuncture could play a more prominent role in the treatment of pain. FDA will soon be coming out with recommendations for doctors to begin advising patients on incorporating alternative treatments, such as acupuncture and chiropractic, to address their pain (source).
In addition to pain management, acupuncture can be used in many chronic and acute diseases and disorders. We all know that acupuncture entails the insertion of needles into specific points of the body, but what exactly is the theory of acupuncture?
Disease,
according to
Chinese medicine, is
when the body cannot cope
with the imbalance and a pattern of disharmony occurs.
What is acupuncture?
Acupuncture is part of a larger body of medicine called Chinese medicine. Chinese medicine began over 2,500 years ago and encompasses many different forms of treatment such as acupuncture, massage, herbs, exercise and nutrition. In the U.S., it is considered a complementary or alternative therapy.
The goal of Chinese medicine is to return balance to the body. The theory is that when the body is imbalanced, disease can take over. Chinese medicine readjusts that imbalance, allowing the body to heal itself. This eastern view of disease differs greatly from that of the western perspective. Chinese medicine works best as a preventive treatment – it helps the body stay in balance, allowing it to readjust and cope with various challenges.
One of the pillars of Chinese medicine is the Qi. A person’s Qi (pronounced Chee) is their energy – their life force. When there is disharmony in your Qi, illness can take over. In Chinese medicine, a clinician looks for a disruption in your Qi; as opposed to modern medicine which places an emphasis on specific structural problems.
Prevention is the key – keeping your Qi in balance.
We all have times of weakness, when our Qi is off. We are all vulnerable to stress, we don’t always get enough sleep, we are overworked...These modern-day realities can throw off our Qi, leading us to disease: pain, cold/flu, skin issues, depression, joint pain, digestive and reproductive issues, cancer – you name it. Disease, according to Chinese medicine, is when the body cannot cope with the imbalance and a pattern of disharmony occurs.
Nutrition is also seen differently in Chinese medicine. As western nutrition generally recommends one type of eating for everyone, in Chinese medicine who we are determines how we should eat. “Foods are selected on the basis of their correspondence with individual patterns modified by the climate, the season, and acute illness. People who are cold and dry need warm, moisturizing food; people who are hot and damp need cool, drying food; people with congestion need decongesting food; and people who are depleted need replenishing food” (source). Of course, this also changes if the person has an acute illness and needs a particular food to push them into balance.
Balance is very important in Chinese Medicine.
Understanding yin and yang
For us Westerners, yin and yang can be a difficult concept to understand. While the Tao is the “whole,” yin and yang come out of the Tao and are symbolic representations that help define and compare relationships between objects. In Chinese Medicine, the yin and yang help clinicians describe what is going on in the body. They are in opposition yet they depend and need each other as they are cyclic. For example, we breathe in (yang); we breathe out (yin).
How does acupuncture work?
There are Eight Principles, which contain four opposite categories, that help the clinician in their examination: yin-yang, cold-heat, deficiency-excess, and interior-exterior. There are invisible organ networks (meridians) throughout the body that moves Qi and blood. Acupuncture points are located along these networks, which are also called gateways, that open and close. The thin, stainless steel needles pierce the skin activating or inhibiting the flow of Qi through these networks.
Organs, in Chinese medicine, are not seen in the same way as Western medicine. Organs are described in five networks and these organs also use the ying yang theory: kidneys and bladder; liver and gallbladder; heart and small intestine; lung and large intestine; spleen and stomach. When treating a client, the clinician determines which of the five organ networks needs treatment and goes from there.
This is a very simplistic overview of Chinese medicine.
To help us understand it better and to learn how it can help you and your family, I sat down with Libby Horesh, owner and founder of Nurture: Whole Health and Reproductive Acupuncture in Concord, MA. Libby is a board-certified in acupuncture and Oriental medicine and a fellow at the American Board of Oriental Reproductive Medicine.
"Everyone has some level of stress in their body,
which is why everyone can benefit from acupuncture."
- Libby Horesh
In my research on acupuncture, I discovered that there are different styles to choose from, which style of acupuncture do you use?
Libby: I primarily use traditional Chinese acupuncture but do utilize Japanese acupuncture at times depending on my client - a kind of hybrid acupuncture. Chinese acupuncture uses more, larger needles and incorporate a little deeper insertion.
On a younger child or an older adult, I may use fewer needles. It truly depends on their underlying constitution and what type of pathology I am dealing with. Someone who is really depleted – maybe they are undergoing chemotherapy or have a debilitating chronic illness, will receive fewer needles than someone who has a robust constitution. I would use fewer needles in this situation since they may not need as many to get the desired result because their sensitivity may be heightened. Sometimes less is more in this type of scenario.
What is the goal of acupuncture?
Libby: The goal of acupuncture is to move and sometimes redirect the Qi or energy in your body. There are two different ways of looking at acupuncture.
One thing I love about being an acupuncturist in this day and age is that we are gaining more and more insight into how acupuncture works from a biomedical standpoint. There are studies showing that acupuncture may impact opioid receptors, release endorphins, control inflammation and lower cortisol levels. There was even a study that came out last year that showed in the treatment of carpal tunnel syndrome, that acupuncture actually remaps the brain!
Acupuncture is so great in that there are barely any side-effects, and can pretty much be used in conjunction with any western medical treatments patients may also be using to help with chronic health issues.
How does your Qi become stagnant or blocked in the first place?
Libby: Your meridians get blocked or congested and this is why your Qi becomes stagnant. Some of the most basic reasons are stress and lack of movement as well as eating the wrong things for your body type. Everyone has some level of stress in their body, which is why everyone can benefit from acupuncture. Unfortunately, the way we live our fast-paced lives creates imbalance for a lot of people.
Even someone who eats the right foods, sleeps eight hours a night - this person still has stress in their lives. Many people do not know about some of the best ways to cope with that stress and some of the ways I typically recommend to my patients outside of acupuncture include meditation and exercise.
Can you help us understand the yin and yang?
Libby: In Chinese medicine, everything goes back to Yin and Yang – excess and deficiency; heat and cold. It is all related to yin and yang. Yin and yang is a continuum. There is yin and yang within everything – in our bodies and in our environment. When using yin and yang to describe imbalance in the body we usually relate excess or deficiency of these to different organ systems in the body such as the liver, kidneys, heart, etc.
What do you specialize in?
Libby: I am one of four people in Massachusetts who is Board-certified in Oriental Reproductive Medicine. I work with women and couples while they are trying to get pregnant, during pregnancy, and towards the end of pregnancy. I can also help with labor preparation and breach presentation. I completed my doula training. Although I am not certified, I use the knowledge from the training to help my patients as they get closer to their due dates. I would love to work in a hospital, helping mothers with pain before and after delivery.
My practice has evolved over the years. I recently finished training in cosmetic acupuncture and I have seen great results. My client’s skin feels healthier and more alive after a treatment. I feel like this is a natural, effective way to help people feel better about how they look. Plus, they are getting the whole-body treatment too. Although the main goal is to treat the face, I have to treat the root cause of the skin issues they are seeking help with - whether it is for dull, dry skin or premature wrinkles.
Who else can you work with?
Libby: Stress, anxiety, depression, obsessive-compulsive disorder (OCD), digestive issues such as Crohn’s disease or colitis, MS, migraines, allergies and asthma – all these ailments present differently. Most of these people are also working with a clinician so I can work alongside their doctor. I hope, in the future, partnerships with the medical communities continues to grow.
Pain is another important area to discuss. I hope acupuncture becomes more prolific with pain management. With the opioid epidemic in full force, acupuncture is an amazing way to help with pain. I really hope doctors and patients start to consider using acupuncture first before reaching for the prescription pad or bottle. There is also a specific ear acupuncture protocol called the NADA protocol that is used in the treatment of recovery from addiction.
"My theory is to give your kids a toolbox when they are young – start them young
by teaching them meditation, yoga, and get them to start acupuncture."
- Libby Horesh
Do you work with children?
Libby: Yes. I think acupressure and acupuncture works great in that it teaches them to be more aware of their bodies – this is important in Chinese medicine. We can teach our children, at a young age, to be aware when their body is out of balance.
Acupressure and acupuncture works well for children. I haven’t worked with too many children with ADHD or ADD, but from what I have seen I think it is helpful for them. Being in touch with nature is important from a Chinese medicine standpoint, so having kids out in nature is important. Last Child in the Woods is a book that I recommend. The philosophy is that ADD and ADHD are prevalent because we are nature deprived. Chinese medicine is connected to the world – connected to the seasons.
So, if your child tends to get ear infections or strep throat every winter, it would be a good idea to bring them in during this time?
Libby: Yes! Sinus infections, ear infections, strep throat – Chinese Medicine can be helpful in helping with recovery from all those ailments. I can see children while they are in the acute illness, however, it is better to come in before they get sick. During the season they usually get the illness – be preventative.
What about stress, anxiety and depression in children and teenagers?
Libby: I am very interested in working with 8, 9, 10 year olds up to teenagers. Kids respond quicker than adults because they are not as deep into their illness or disease. Children may have had anxiety for a few years rather than for 20 years. Typically, the longer you are out of balance, the longer you need regular treatment to get back into balance.
Chinese medicine is such a great alternative to medication but can be used in conjunction. I’ve worked with parents trying to avoid anti-anxiety medications –they are looking for alternatives. Of course, some children absolutely need medications, and they can make that decision.
My theory is to give your kids a toolbox when they are young – start them young by teaching them meditation, yoga, and get them to start acupuncture. They should continue seeing their therapist or clinician during this time, but by introducing them to these alternative ways of treatment, you are giving them a gift. As they go through life, they can reach into their box and find tools to help them. When they are 20 years old they can ask themselves, “I am feeling anxious right now, what has helped me in the past?” They can reach into their toolbox and find what they need.
Can you describe how the seasons fit into Chinese medicine?
Libby: In Chinese medicine eating seasonally is very important. In the winter, it is important to eat warming, nourishing foods such as soups and stews. In the spring and summer, that is generally when you can eat lightly cooked foods as well as spring and summer vegetables. The fall tends to be the time of year when the air gets drier, and so making sure you are adding moistening foods such as sweet potatoes, pears, and broths into the diet can be helpful. The important thing to remember with this, however, is that we need to take into account everyone’s underlying constitution. Some people will have a hard time digesting raw foods even in the summer, just as other people shouldn’t go overboard with really warming foods in the winter if they tend towards too much heat in the body.
Can you tell us how you incorporate herbs?
Libby: Before starting herbs, I typically try to do 3-4 weeks of just acupuncture, and then check in to see how the treatments are working. I don’t always need to do herbs. If I can just treat you with acupuncture, then I try to be as least invasive as possible. However, in China when someone talks about Chinese medicine, they are usually talking about herbal medicine. It is a very powerful tool that I incorporate into my practice when I feel like it is appropriate and necessary to get the results we want. Usually I give my patients herbs in the form of a powder that they dissolve in water, an alcohol or glycerin-based tincture, or pills.
It is important to get your herbs from a reputable place and find someone who has the training because Chinese herbs are powerful and they work the used appropriately. In China, herbs are the predominant tool used in Chinese medicine while in the US, acupuncture is more popular.
The tongue plays an important role in Chinese medicine. Can you explain what you look for during a tongue reading?
Libby: At every appointment, I take the client’s pulse and I look at their tongue. Their tongue gives an external picture of what is going on in the internally. I may ask them to give up certain foods or drinks. In Chinese medicine, these foods may be feeding their imbalance – dairy, sugar etc. However, this can get complicated.
I look at the shape of the tongue – are there ridges around the edge? Is it scalloped? I look at the color – do certain parts of the tongue have different colors? Is there a coating? If there is a coating, what color is the coating? White or yellow? These mean different things from a diagnosis standpoint, and I would treat the patient with different points or herbs. I look under the tongue – is it really veiny? If it is really veiny this means there is stagnation. The tip of the tongue can show stress and stagnation. The tongue can also show the practitioner there may be a digestive imbalance.
Since digestive imbalance seems to be prevalent in our society, what is your advice for families?
For children, I tell them that what you are feeding your body 3-4 times a day is the most important thing. It is difficult in the world we live in to teach children the importance of healthy whole-foods based eating. My philosophy is if we can feed our kids in our own home as healthy as possible, then when they go out in the world, they are a step ahead.
In our house, we try to make sure our children don’t feel like we are being restrictive with what we eat, but just reinforcing the idea that what we eat impacts our body and our health. I want children to ask themselves, “Is that food going to make me feel better or worse?” Being self-aware; knowing how their body feels when they eat that way is key.
I want to thank Libby for her amazing insights into the world of Chinese medicine. If anyone would like to work with Libby Horesh or learn more about her work, contact her at
To find other board-certified specialist in Chinese Medicine and acupuncture in your area, go to
www.nccaom.org/find-a-practitioner-directory/
To learn more about seasonal eating in Chinese Medicine