The Heart plays the central role in awareness, and in all aspects of human psychology. The spiritual force of the Heart is dominant in the development and function of all the other energetic forces related to the mind, spirit, and soul. The Heart controls the mind; mind affects the Heart. In Oriental terms, the key to subtle unspoken awareness is an open Heart: free of desire, craving, addiction and its pursuit. As Claude Larre and Elizabeth Rochat de la Valle wrote, “By nature, man’s Heart is vast and free like Heaven: always tempted to fill itself, it must seek to become empty. An empty heart can receive.” What fills the Heart instead is desire, and craving interferes with awareness. Life is spoken of as a “rambling walk directed by the Spirits.” This “long life, everlasting vision and rambling walk” can be damaged.  “For life to be fulfilling, one must allow the Spirits to guide the Breaths through life.”

The Pericardium and Triple Burner acknowledge and express this awareness with words. While the Heart is the emperor, the Triple Burner runs the empire. Water grounds us in the here-and-now. Wood provides direction. Metal, when healthy, provides flexibility. The Earth Phase bears the milk of human kindness and fulfils the basic “need”. This is the beginning of self-worth. The Heart yin is the medium that enriches that ‘milk’ into the ‘cream’ of human congeniality, and fulfils the basic “want”. Here is the source of all joy.

Perhaps the most important consequences of the introduction of acupuncture into my practice were the flowering of awareness in my patients, and my own appreciation of its significance to growth and development. Awareness is the centerpiece of Zen Buddhism, and is almost synonymous with the concept and experience of enlightenment. The Heart fire energies are deeply concerned with “creative awareness and expression”.

Heart yin inspires that substance (from Kidney yin) into awareness and Heart yang gives form to the creative idea. Fire energies dominate consciousness, and the awareness of creativity and love. Because of this, Fire energies are placed in the center of all interpersonal considerations. In terms of consciousness and awareness, the Fire Phase contacts the general energy (Heart), distributes it fairly (Triple Burner and Pericardium), and purifies it (Small Intestine). On the level of feelings, and at their supreme maturation, these energies nourish and govern the awareness and the expression of unconditional love, both for self and for others. Heart energies are responsible for the higher, conscious, intellectual-mental “investigation of life”, including: awareness, “symbol formation”, and the communication of ideas and feelings.

The heart “opens” to the tongue, and is embryologically close to the throat. There is a Hindu saying: “If one can close off the throat, one closes off the flow of thoughts.” The Heart controls the circulation of ideas within and between men. Only through Heart yin energies do the Divine Spirit, Divine Love, and Divine Will come into conscious human awareness. Divine revelation is the gift of Heart yin. A deficiency of Heart yin will manifest as a lack of awareness and consciousness of the inner self. An excess of Heart yin energies involves a greatly enhanced awareness of both the inner chaotic world of the unconscious, and the constantly-impinging sensory and emotional stimuli from the outer world. Too much of a good thing is destructive.

All of the following clinical issues mentioned in the language and concept of Chinese medicine –phlegm, fire, deficient heat, trapped Qi, Qi and yang deficiency, closed orifices, blood stagnation –interfere with the ability of the Heart to fulfil its energetic function. It is therefore unable to maintain contact with, and sustain full awareness of, the outer world of interpersonal affairs as well as the inner mental, emotional and spiritual worlds. Depending on the degree of interference, as well as other variables (such as constitution, shock, trauma, nutrition work, exercise and habits (drugs, sex, etc.)), there can be a wide variation in the severity and the nature of symptoms associated with a loss of awareness, due to an impediment of Heart and other Fire energies.

Almost all psychological disorders can be understood as a function of awareness, either in quantity, quality (perception and distortion) or form. In fact, in Old English the words insanityand alienation were linked, denoting a loss of awareness of what is coming to, or emanating from, the inner world (boundaries).

The principal problems that attend human relationships fall mostly into the realm of communication. Fire energies are all about communication. Heart yang and Pericardium yang, Triple Burner and Small Intestine energies are all involved in the appropriate and effective expression of thoughts and feelings. Where the clarity of communication is involved, all of the distortions attending maladaptive discourse are rooted in awareness. They are, therefore, also ineluctably rooted in the integrity of the Heart and Fire phase. Therefore, all human problems, from marital and family conflicts, to the most serious neurosis and psychosis, are to some extent the manifestations of defects in Fire energy performance.

For more information regarding psychological disorders related to Heart function, I refer you to chapter 15 in Chinese Pulse Diagnosis: A Contemporary Approach (pp. 547-8 and the glossary), and chapter 14 of Dragon Rises, Red Bird Flies (pp. 316-319; 333-338).