Acupuncture and Suggestion Therapy for Hysteria Treatment

Hysteria is a clinically common condition caused by mental stimulation, resulting in temporary dysfunction of the cerebral cortex.

Various mental traumas are the primary causes of onset. The onset of the condition in patients mostly depends on long-term personality traits, manifesting as unstable temperament, high suggestibility, and a rich tendency toward fantasy. Since childhood, they have prioritized emotions over rational control in all matters, centered on themselves, and are adept at self-aggrandizement. If these traits are not promptly addressed through education and correction, they develop into the pathogenic basis of this condition. Due to long-term behavioral changes as described above, the first and second signal systems between the cerebral cortex and subcortical regions lose their normal regulatory balance, leading patients to exhibit a wide variety of signs of imbalance.

I. Diagnostic Key Points

The clinical signs of imbalance of this condition are diverse, often manifesting as episodic clinical presentations involving motor, sensory, autonomic nervous, and mental disturbances.

1.Movement dysfunction

Manifestations include enhanced, diminished, or absent motor functions of the limbs, such as epilepsy-like convulsions, tremors, limb paralysis (monoplegia, paraplegia, hemiplegia), and peculiar gaits (e.g., scissors gait). Detailed physical examinations fail to reveal any clinical pathological signs, such as the absence of diminished tendon reflexes or inducible pathological reflexes in patients with paralysis.

2. Sensory disturbance

There is hyperesthesia, hypoesthesia, or anesthesia of the skin, distributed in a glove-like or stocking-like pattern. The characteristics of skin sensory disturbances are as follows: the location of the sensory disturbance does not conform to the normal distribution of nerve endings, and the boundary between the normal and affected areas is abnormally sharp and distinct; when the hyperesthetic area is touched, the patient exhibits an expression of unbearable pain. Patients with “hysterical globus” feel a balloon-like mass in the lower abdomen that gradually ascends, obstructing the stomach and throat, leading to hiccups, a feeling of blockage, and suffocation. Additionally, patients may experience signs of imbalance such as deafness, blindness (hysterical amaurosis), and aphonia. Patients with this type of deafness can be awakened from sleep. Blindness in these patients often occurs suddenly, with no ocular wellness detected upon examination; there is a clear mental factor preceding the onset, and the visual field shows bilateral symmetrical constriction, presenting as tubular vision. Patients with aphonia can still cough.

3. Vegetative nervous signs of imbalance

Common signs of imbalance include neurogenic vomiting, anorexia, frequent urination, pseudopregnancy, etc.

4. Mental signs of imbalance

Common signs of imbalance during episodes include uncontrollable laughing or crying, shouting or screaming, incoherent speaking or singing, and wild gesticulations, often accompanied by exaggerated performances. Patients may express inner distress through dramatic movements and vivid expressions, with episodes typically more pronounced in crowded settings. Some individuals may suddenly collapse during emotional excitement, becoming unresponsive with rigid bodies and trembling limbs. Breathing patterns may involve breath-holding or hyperventilation, resembling grand mal seizures, but without frothing at the mouth, bite marks on the lips/tongue, or impaired consciousness. Episodes may last from tens of minutes to several hours.

II. supports

Acupoints during the onset phase

1. Acupoints and Acupuncture Techniques

1.1. LI4 (Hegu) (bilateral): Located between the first and second metacarpal bones on the dorsum of the hand, at the midpoint of the radial side of the second metacarpal bone; Select two 30-gauge, 2-cun filiform needles, perform routine local disinfection, and insert approximately 1.8 cun in the direction of SI3 (Houxi); Needling sensation: Local distending pain.

1.2. ST36 (Zusanli) (bilateral): Located 3 cun below Dubi (ST35) at the knee, 1 finger-breadth (middle finger) lateral to the anterior crest of the tibia; select two 30-gauge, 2-cun filiform needles, perform routine local disinfection, and insert perpendicularly to a depth of approximately 1.8 cun; needle sensation: local distension and pain or radiating sensation toward the dorsum of the foot.

2. Method

After accepting the patient, place them on the supports bed in a supine position and conduct a comprehensive and meticulous physical examination (even if it can be determined to be hysteria, do not disclose it and complete the examination). The examination includes auscultating the Heart and Lungs, percussing the chest and abdomen, testing patellar tendon reflexes, scratching the sole of the foot, measuring blood pressure, etc. After confirming the assessment as hysteria without error, the practitioner begins verbal supports (suggestion therapy). First, inquire with the patient’s family about the patient’s age (never ask about the cause of the onset) and the time of onset. Then, ask those around to remain silent and maintain quietness, allowing the patient to rest well (showing consideration for the patient). Instruct the patient’s family to have only one person answer when the doctor asks questions, and tell the patient that when they can answer by themselves, no one else should answer on their behalf. Then, inform the patient that acupuncture is about to begin, and tell the patient that for the first needle at LI4 (Hegu) (for males, needle the left side first; for females, needle the right side first), after insertion, the patient should feel able to speak or speak clearly. After the insertion of the second needle (LI4 (Hegu)), the patient’s head and face will feel relaxed, and the eyes can be opened. After the insertion of the third and fourth needles (ST36 (Zusanli)), the patient will feel relaxed throughout the body, and the condition will completely improve. After inserting the above acupoint needles, inform the patient that the needles need to be retained for 20 minutes before removal, and even if the patient feels completely better, they should persist in completing the supports. When removing the needles, patiently inform the patient that five more acupuncture sessions are needed to complete one course of supports, and after the course, the patient’s feelings of annoyance, distress, and fear will be completely eliminated, and the mood will become cheerful and open. By the time the above explanations are finished, it is time to remove the needles. When removing the needles, inform the patient again that needle removal is painless, and after the needles are removed, the patient will be able to walk freely. Remove the needles to conclude the initial supports. For the subsequent five treatments, use acupoint selection during the intermittent period.

Acupoints during the intermission period

1. Acupoints and Acupuncture Techniques

1.1. Taiyang (bilateral): Located in the depression approximately 1 cun posterior to the midpoint between the outer end of the eyebrow and the outer canthus of the eye; select two 30-gauge 2-cun filiform needles, perform routine local disinfection, and insert approximately 1.8 cun toward the Shuigou (GV26, but in context should be Shuigu – rate valley point, likely Shuigu (GB8) here) point; needle sensation: local distending pain.

1.2. Neiguan (PC6, bilateral): Located 2 cun above the transverse crease of the wrist on the palmar side, between the palmaris longus tendon and the radial flexor carpi tendon; use two No. 30, 2-cun filiform needles, perform routine local disinfection, and puncture perpendicularly approximately 1.2 cun toward the contralateral Waiguan (SJ5); needle sensation: local distending pain or radiating sensation to the dorsum of the hand and the middle finger.

1.3. CV15 (Jiuwei): Located on the anterior median line, 0.5 cun below the xiphoid process and 7 cun above the umbilicus; use a No. 30, 4-cun filiform needle, perform routine local disinfection, insert the needle tip downward at a 25-degree angle to the skin to a depth of approximately 3.8 cun; needle sensation: local distending pain.

1.4. Xingjian (LR2) (bilateral): Located at the end of the web margin between the first and second toes on the dorsum of the foot; Take two 30-gauge, 2-cun filiform needles, perform routine local disinfection, and obliquely insert the needles upward to a depth of approximately 1.8 cun; Needling sensation: Local distending pain.

2. Method

The patient should be placed in a quiet room in a supine position. Needles should be inserted into the acupoints as described and retained for 1 hour without twisting or removing them prematurely. During needle retention, the patient should be instructed to try to fall asleep. When it is time to remove the needles after 1 hour, the patient should be gently awakened first, and then the needles should be withdrawn. This supports should be administered once daily. After 5 sessions, needle retention should be discontinued. One supports course can be administered monthly.

III. Comments

Acupuncture combined with suggestion therapy demonstrates unique efficacy for this condition, with success depending on three key factors: the physician’s appropriate use of language, precise acupoint selection, and a quiet supports environment. However, the most critical element is the outcome of the initial acupuncture session—successful first supports significantly enhances subsequent therapeutic effects and ensures satisfactory results, while failure reduces prospects for full recovery. After recovery, patients should be advised to engage in regular physical exercise to strengthen their constitution, maintain mental and emotional well-being, and help sustain the therapeutic benefits.