Does any of you know what is this "Qi-Gong Psychotic Reaction: DSM-IV " and what are de symptoms?
thank you,
Jorge
The DSM IV is a standard psychiatric reference textbook for doctors. Psychotic reactions vary according to the patient.
The following link will tell you about the book:
http://en.wikipedia.org/wiki/DSM_IV
Also:
And this one about psychoses:
politization
The extent of psychoses is exaggerated in the present system because of abuse and psychological aggrandizement on the part of government. The mainland party, like the Soviets before them, uses psychiatric diagnoses as a way to discredit foes (in this case falungong). Mental health facilities are non-existant and as result, for the few cases that do exist, go untreated and unresolved, laying the blame on qigong!
Qigong fraud is also rampant with people claiming to cure mental diseases with their brand of yangshenggong.
you need to keep the DSM in perspective.
It serves several basic functions.
One is to give a similar diagnosis foundation for mental health professionals across different countries, cultures, etc…
However, if you are talking about its uses in the US…
The BIGGEST use and important aspect of the the DSM is its use in diagnosis for patients being seen in a professional setting where INSURANCE or 3rd party copay is involved.
Basically, the therapist/doctor will always choose a DSM disorder that (A) fits the patient’s complaints the closest and (B) is one that the patients 3rd party payer as in Insurance, Medicare, Medicaid, or whatever - will cover and pay for.
You will NEVER see a patient in a psychiatric facility with a disorder from the DSM that is NOT one that the insurance company pays for.
Putting it into perspective :
Adolescent Adjustment Reaction - a VERY common diagnosis for just about any adolescent in any treatment facility.
Defined as :
“An adjustment disorder is defined as an emotional or behavioral reaction to an identifiable stressful event or change in a person’s life that is considered maladaptive or somehow not an expected healthy response to the event or change. The reaction must occur within three months of the identified stressful event or change happening. The identifiable stressful event or change in the life of a child or adolescent may be a family move, parental divorce or separation, the loss of a pet, birth of a brother or sister, to name a few.”
Now, if the adolescent in question has insurance or a family with money and insurance, they are diagnosed as having Adolescent Adjustment Reaction and spend time in a treatment facility.
If they don’t have the insurance, have a family that is loathe to use psychiatrists, or don’t have money, AAR all of a sudden becomes delinquent or some such behavior and the kid ends up in front of a judge and then in juvenile detention.
Amazing how money works 
So, is there some politics in a Qi Gong Psychosis - yes. It CAN be families trying to get a person out of a cult…but it can also be families trying to get the strange one that got stranger some help.
Every instance is different. But…at the same time, keep in mind that if you have gotten drunk TWO times in the past year, according to the DSM, you may have an alcohol abuse problem. (the two times do NOT exclude New YEar’s and Labor Day)
well … i can see by your reply that you dont take DSM-IV very serious but … did any of you read the “Qi-Gong Psychotic Reaction” chapter? Even if they exagerate i would like to know what are the symptoms … i dont want to buy the book just to read that chapter … so if anyone knows what are the symptoms in the book i will appreciate very much if you share the information.
thank you all for the reply,
enjoy,
Jorge
Hi alquimista,
I’m still looking for a better link, but try this one for now:
Thank you Scott … It´s a very interesting link with a lot of symptoms that can happen during meditation http://www.spiritualcompetency.com/dsm4/lesson3_5.html
It doesnt say much about the DSM IV-Qi-Gong Psychotic Reaction but i guess its should be very similar.
I conclude that those symptoms are all related to a “Yang Rising” TCM syndromes that happen because the meditation focus to much on the “heaven” and too little on the “earth” or because a person has a lack of Yin energy. I feel in my body some of this Yang Rising symptoms when i practice meditation for long periods. One day i realized that the symptoms decreased when i meditate and breath also with my legs and feet or when i meditate in grounding stance (tree stance) with my feet in the grass and with the palms of my hands turning down to get the Earth Yin energy.
Some of the symptons described on the link can be very serious mental psychotic disorders … i think that can only happen if someone is not ready (balanced) to practice meditation like schizophrenics or other serious unbalanced persons who insist to meditate.
I think that a person with a balanced body/mind (Yin/Yang) and with a good Earth relation during the day activities should not feel any “Yang Rising” symptoms during the meditation practice (even when your kundalin awakes).
Thank you all for cooperating in this thread,
Jorge
Hi alquimista,
I am trying to locate the actual DSM entry. I thought I had a copy of it at work, but I can’t find it right now! I’ll keep looking.
I really don’t consider it having anything to do with Chi or Chi Kung. The vast majority of people suffer no ill effects from Chi Kung even when they practice it in what may be considered by some the “wrong” way.
All things may be abused and all things affect each individual a little differently. IMO the individuals who suffer psychotic symptoms had a lack of basic emotional maturity or psychotic tendencies in the first place. Chi Kung practice is nothing more than a stimulating event. If an individual is emotionally unstable to begin with or does not have the tools to correctly handle and interpret the resultant experiences they may experience negative effects, but it is not the fault of Chi Kung. Destabilizing events can be anything from substance abuse to acute or deep seated traumas. People with delusions of grandiosity generally have deep seated insecurities to begin with.
Some who drink alcohol become alcoholics; some who drive cars get in accidents. In America over the recent holiday we had a BASE jumper fall to her death when her parachute didn’t open. I can step outside tomorrow and get struck by lightening. Life is full of risk and nothing is ever guaranteed. Is it alcohols responsibility that someone becomes an alcoholic, is the parachutes responsibility the BASE jumper died, is it the cars responsibility someone crashed it? Individuals are responsible for their own actions, not the inanimate objects that were the means of their undoing.
It is not that I don’t take the DSM IV seriously… it is just that I was in the mental health field (back when it was the DSM III) and before I went into engineering.
The ONLY time a therapist or a psychiatrist pulled out the DSM was to get the approved code for a patient to make sure their insurance would pay for hospitalization or sessions. In the academic world, it was pulled out to classify a subject into the right bucket for statistical analysis.
It DOES have a good broad brush of what the various basic disorders are - classes and such.
If you are an MD (psychiatrist with prescription drug privileges), you can get an idea as to what drugs to give.
But, if you are a therapist, you still have to do the work to devlop a relationship and work through the issues.
Psychosis is one of those things that requires drugs and then therapy. Very often, the therapy ends up centered around how to live with the drugs.
Then, you have drugs to counteract the side effects of the anti-psychotic drugs - like Haldol as an anti-psychotic and Cognetin for the EPS (side effects). Problem is, the side effect drugs can often produce psychosis too.
Qi Gong Psychosis – then TCM ideas…this can get really messy since you would be using a western diagnosis modality and then switching to a TCM treatment modality…and they rarely map easily.
Scott … i will apreciate very much if you can find the DSM chapter about the ChiKung Psychotic Reaction … thank you
cjurakpt … thank you for the links … i get a lot of information about Qigong Psychosis in the 2nd link
GLW … i didnt know that psychiatrists in US use DSM only because of the insurances … maybe they do the same in Europe … interesting … but i really want to know what DSM says about “Qi-Gong Psychotic Reaction” … are you a TCM student or a TCM therapist ?
thank you all,
Jorge
qigong problems
“Devil running fire” is the translation of the term associated with adverse experiences in qigong circles. It has many manifestations like moderate to severe anxiety, heart palpitations, self harm (manifesting as cutting off one’s hands, arms, legs, etc) or psychoses, schizophrenia and delusional behaviour.
DSM-IV is a Western coding tool relating for reimbursement for insurance and doesn’t say much on the matter. Only that it has a potential code.
Many of the ‘devil running fire’ group may have undiagnosed mental health issues (Mainland China does not believe in mental health per a Western framework) but with modernization, they will see a 100 fold increase due to rapid societal shakeup that will point to the less vulnerable.
Mawali pretty much got it.
The entry in the DSM was probably made so those treating Chinese patients could put a diagnosis to something. It is doubtful that any insurance or third party copayer would accept that particular diagnosis (at least in the west…no telling what would happen in someplace like Singapore).
But what you do get from having it is a nice place for the mental health professionals in China to get hooked in to the whole DSM process - statistcs, tracking…and eventually coopting them into the western view of psychiatry.
while this may sound weird, in the PRC, anti-psychotic drugs are expensive and not readily available. They also tend to prescribe lower doses for similar patients than do their western counterparts.
The main mode of treatment is to use the drugs to get a level of normal functioning and then switch into the “Long Discussion” —or some such phrase which basically means very deep one on one sessions with a therapist (or lay-therapist) - and this tends to be closer to reality therapy than strange things like…oh…Freudian analysis
But, western psychiatric treatment is more geared to the 45 minute hour, pills, and not spending the depth of time needed with each patient. In a western setting, if the patient hits on something that is a breakthrough at 44 minutes into the hour, the therapist is winding down and talking about picking up there next time (meaning that it takes that much longer).
In the Chinese version, they tend to keep going and actually accomplish something. Part of this is the culture and philosophy. The other part is that it is of no advantage in China for a therapist to drag treatment out for years or to have a relapse. They don’t have the insurance/get rich on the patient approach.
When you see a psychiatrist come into a hospital where their patients are and hit one floor after another…starting at the top and working down…and then having the nursing staff round up their patients on each floor and herd them in one at a time…for 5 minutes max…and then realize that each patient was charged for a 45 minute hour PLUS the charge for hospital treatment from the shrink, you begin to see how the mental health field has a big racket going on.
And the really good therapists are the ones that get burned out and leave the field
I have studied some TCM and follow my Qi Gong teacher who is a TCM doctor and was a founding teacher of the Shanghai College Of TCM…before he retired. - to answer the question…
Mawali … some translated also has “Mislead the fire and enter the devil”, in PiYin is “Zou Huo Ru Mo”. I know already a lot about Qigong deviations by Chinese and TCM point of view but im looking now for the western point of view. I dont want to discuss if DSM is good or bad … i just want to know what does it say about “Qi-Gong Psychotic Reaction”. You say “DSM-IV is a Western coding tool relating for reimbursement for insurance and doesn’t say much on the matter” … have you read it? What does it say about “Qi-Gong Psychotic Reaction” ?
GLW … i think everybody got it … i agree with everything you say … the point is that anyone here knows for sure what DSM says about “Qi-Gong Psychotic Reaction” … do you know?
The point in this thread is not to discuss about DSM or Qigong deviations, but about what DSM says about “Qi-Gong Psychotic Reaction”. Maybe we can start another thread so we can share what we know about qigong deviations or discuss about DSM and learn more about it. For now i would like to know what DSM says exactly about “Qi-Gong Psychotic Reaction” and … since you all know so much about DSM … maybe you can help me to find out …
thank you a lot for your effort and patiente in helping me with this question,
Jorge
Hi Jorge,
Apparently the DSM-IV really doesn’t say much about Qi Gong psychotic reaction. Here is the listing I have found it is only from citations of the DSM-IV. I cannot find the DSM-IV at work yet.
DSM-IV Appendix I:
This appendix lists cultural specific disorders and there quite a number of them. There is no diagnosis number that I have been able to determine and all the DSM really says is:
[B]Qi Gong psychotic reaction:
A time-limited episode characterized by paranoid and other psychotic symptoms. Can occur after participating in the Chinese folk health-enhancing practice qi-gong.[/B]
This is basically what has been cited in many of the above links.
I have 4 years experience with acute psychotics in nursing, running the daily programs and participating in therapies and groups as well as Doctors interviews and I can confirm that everything that GLW and cjurakpt have said is accurate about the Western or at least American Psych system.
Wow, sounds like people have seen some bad psychiatric care.
At the hospital where I work, there are treatment teams. Each patient is assigned a psychiatrist, a social worker, an occupational therapist, and a nurse. Of course, the nurses rotate through, according to the shifts they work, but we chart pretty thoroughly so the docs and residents and everyone else on the team can follow a relatively seamless description of day to day changes.
In my experience, it is not the psychiatrist’s role to treat with therapy. Psychiatrists are there for medication management and to direct the overall treatment goals. To be honest, psychiatrists, being MD’s are simply too expensive to rely on to conduct therapy. There is no reason why someone needs to be an MD to conduct therapy, and further, acute inpatient care isn’t really the time to begin therapy anyways. The only reason for a patient to be in inpatient psychiatric care is that they are in some kind of crisis, so on some level they are a threat to themselves or someone else. Once they’re stable enough to leave, then they are in a good position to benefit from therapy, and if someone wants therapy, regardless of their ability to pay for it, their social worker can probably find something that is available to them. The fact is, many if not most patients would rather just take a pill. In adult inpatients, there is an extremely high comorbidity of substance abuse and psychiatric illness, and many of these patients refuse to take responsibility for themselves, so they will not follow up with any treatment that, like therapy, requires a great deal of effort on their part.
As far as the DSM, it is mainly a reimbursement tool, and there’s nothing wrong with that. Psychiatric illness is by its very nature more nebulous than physical ailments. The DSM allows for people in the position to make a clinical judgment about a patient’s need for care to make that judgment. Any other way and you are likely to exclude from treatment people who really need help.
The mental health system in the U.S. is flawed for sure. Thank Ronald Reagan and de-institutionalization for one thing and the tendency of people (within the medical community as well as without) to not really respect psychiatric medicine as a valid branch of medicine. Still, the idea that it is some kind of racket is somewhat ludicrous to me. Most people involved in mental health are overworked and underpaid. Nurses are paid the same salary in our facility as in the regular hospital, which is as it should be, but psych nursing does not command the respect that other nursing positions do, and you can see how it slowly wears away at the people who do it. As far as psychiatrists, in the hospital setting you are seeing fewer and fewer residents who want to go on to be psychiatrists because the earning potential is not nearly what it is in other areas of medicine. Maybe it’s different in other places or in private practice. Further, psychiatric units as parts of large hospitals often barely get by, or even operate at a loss. The types of patients that are in need of acute care often do not have insurance, so you’re talking Medicaid (at best).
Hi dwid,
I did not intend my comments to be taken in a negative respect. My clinical experience is very similar to the one one you have outlined, with the exception that mine took place in a Correctional setting. To be honest with you I have somewhat of a knack for Psych nursing so I did not find it stressing in the least. Most of my stress was caused by fixing the problems caused by inept or immature staff.
I agree with you about about the Psychiatrist, it isn’t their job to spend a great deal of time with the patients. That is left to the many others in the therpeutic team. I must also admit that many or maybe even most of the Psychiatrists I have worked with were as nutty as the patients, mostly neurosis though rather than psychosis, but some psychotic controled with meds, LOL!!
I didn’t really take your comments negatively, I just wanted to add my perspective to the mix. I’ve actually given thought to going to work in the Correctional system myself once I finish school. The pay is very good for NPs, and I think you probably see a broader spectrum of diagnoses than you do almost anywhere else. In the private sector, most psychiatric professionals compartmentalize and just treat a particular level of acuity, type of patient, etc…, but in Corrections you have acutely ill people and also people suffering from a mental illness that is subacute and requires treatment.
LOL, I think it helps to be a little nutty in this field. And it takes a particular type of person to be suited to the environment. As far as the shrink with more severe mental illness, I think that’s what gets some people into psychiatric work in the first place, just trying to figure themselves out
Ok … i found it … this is what DSM-IV says:
Qi-Gong Psychotic Reaction: DSM-IV General Information: Appendix I, Outline for Cultural Formulation and Glossary of Culture-Bound Syndromes:
qi-gong psychotic reaction A term describing an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or nonpsychotic symptoms that may occur after participation in the Chinese folk health-enhancing practice of qi-gong (“exercise of vital energy”). Especially vulnerable are individuals who become overly involved in the practice. This diagnosis is included in the Chinese Classification of Mental Disorders, Second Edition (CCMD-2).
There is a new edition of CCMD-2 (CCMD-3) and say this:
42.1 Mental disorders due to Qigong [F43.8]
In the tradition of our country, Qigong is a way to keep healthy and cure the sickness. The method is usually to keep special posture or practice some exercises, and keep concentration on some points, pondering and reading silently, relaxation and regulating respiration.
Mental disorder due to Qigong refers to the phenomena that an exerciser is kept in a state of Qigong for so long as not to stop because of improper operation of Qigong (e.g., excessive exercise), the manifestations include symptoms of thought, emotion, and behavior, loss of ability of self-control.
A. Symptom criteria:
(1) Directly caused by Qigong exercise;
(2) The symptoms are closely related to the content of Qigong books and periodicals, and exercise of Qigong. The patients show abnormally mental symptoms repeatedly and continuously, without self-control;
(3) With at least 1 of the following:
psychotic symptoms, e.g. auditory hallucination, delusion;
hysteria-like syndrome;
neurosis-like syndrome.
B. Severity criteria:
Impairment of social function;
C. Course criteria:
The course is transient, patients may recover immediately by being out of spot, stopping exercise and proper treatment.
D. Exclusion:
(1) Excluding similar manifestations regarded as tricks to cure the sickness for oneself or others, or tricks to obtain money or attain other goals, excluding similar manifestations that can be involuntarily self-induced or self-ended;
(2) Excluding any kind of other disorders, especially hysteria or stress disorder due to psychological trauma.
I got the answer for my question, the symptoms for Qi-Gong Psychotic Reaction by western psychology in DSM and CCMD are:
. Directly caused by Qigong exercise
. an acute, time-limited episode characterized by dissociative, paranoid, or other psychotic or nonpsychotic symptoms
. symptoms of thought, emotion, and behavior, loss of ability of self-control
. abnormally mental symptoms repeatedly and continuously, without self-control
. psychotic symptoms, e.g. auditory hallucination, delusion
. hysteria-like syndrome
. neurosis-like syndrome
. Impairment of social function
. Excluding any kind of other disorders, especially hysteria or stress disorder due to psychological trauma
I think it will be better to start a new topic if you want to continue changing information about psychology so more people in the the forum will be able to share also they experiences
Thank you for helping me … cjurakpt, GLW, mawali and Scott
Enjoy,
Jorge
Thanks to Scott for posting that listing of the DSM description.
It was something I had read earlier and my take was “Typical DSM IV - falls into the category of that’s nice, but so what”
The description doesn’t tell you much and can be used to even describe a person who might describe seeing lights as brighter or haloed…or seeing auras after practicing Qi Gong. That does not mean that it WOULD be used that way.
However, I HAVE seen such vague diagnosis areas used to keep people committed under a psychiatric warrant based upon ulterior motives in the family (like the rich male patient who didn’t get along with his wife, left and spent all of his time living on his docked sailboat, drinking beer and fishing…and she would have him committed about once a year to try to get a power of attorney over his assets. He MAY have had a drinking problem but he was sharp as a tack and was still making money…and the only person he ever had an issue with was his wife.)
Wouldn’t it be just fine if such a diagnosis was also used by a husband to get his wife committed so then he could divorce her and keep custody of the kids? In such an instance, if the wife got upset and argumentative about being incarcerated, the nursing staff would log it as inappropriate behavior. If the wife were to take things in stride and then continue practicing Qi Gong, the doctors and nursing staff would probably mark that as “strange behavior” and still, it would be used to keep her hospitalized.
Not that far fetched.
For Qi Gong side effects, I would say it would be more valid to examine the things that are listed in TCM and totally ignore the DSM IV.
The point is really moot from the perspective of practice here in the U.S. No psychiatrist would ever use that diagnosis for inpatient documentation. At least from my perspective, most psychiatrists rely on the DSM as little as possible. Someone with psychotic symptoms and no history of schizophrenia or other psychotic illness would simply by written up as Psychosis NOS and that would be their diagnosis until a more useful or valid diagnosis could be obtained.
As far as the other stuff re: commitment with ulterior motives. That’s some wild stuff. I’m sure it happens, just like wives falsely accuse husbands of domestic violence to gain leverage, etc… A good staff would figure out the game pretty quick though. We don’t just watch people and take copious notes on their behavior. We talk to the patients and try to understand what’s going on from their perspective. In acute care, you can separate the people who belong on the unit from those who don’t pretty easily in most cases just by spending some time with a person.