Yin-Yang Imbalances in the Time of Covid-19

I am sitting outside on our porch swing on a beautiful early spring day in Washington, DC.  Trees on our street have started to bloom yellow, pink, and purple.  The sun is shining brightly and I feel a gentle breeze brushing my face.  It is early April 2020, a spring all of us will remember as the time of the COVID-19 pandemic.  Due to the shelter-in-place orders, there are no cars driving past our house.  Only very occasionally do I see a person passing by as a neighbor walks her dog or another neighbor takes his toddler outside for some fresh air.

We live in the middle of the city, so this quiet is highly unusual, especially on a gorgeous spring weekend day.  I can hear the songs of dozens of birds, and if it weren’t for my eyes looking around at the houses, apartment buildings, and parked cars on this densely populated street, I might be fooled into thinking that I am actually sitting on a different porch swing somewhere in the middle of the country.

It is springtime:  the season following winter, which is the darkest, coldest, quietest, most still time of year.  Winter is the most Yin time of year, according to Chinese Medicine (CM), during which the earth calls us to follow her rhythms.  These rhythms heed us to slow down, sleep more, work less, do less, and experience more stillness.  Winter is the time when many animals hibernate, the trees are bare, seeds are buried underground beneath frozen layers of earth.

Spring is a pivot point between the deep, dark Yin of winter and the early burst of Yang associated with longer days (more hours of sunlight), animals coming out of hiding, seeds pushing through the no-longer frozen ground to blossom, trees growing their leaves.  Like all visions, spring’s vibration of coming to life begins long before it manifests outwardly.  What has been held deeply under the earth (or within each of us) during winter takes shape and form in the springtime. In springtime, the earth calls us to move from our place of deep rest and quiet introspection into more activity, more time outside.  Earth calls on us to initiate the plans and visions developed within us during the time we spent in quiet introspection (hibernation) during the winter.

In the clinic, I work with my patients during winter to cultivate the stillness, quiet and introspection that is needed for them to manifest new visions or dreams in the springtime.  When we do not allow ourselves this extended period of stillness during the most Yin season of the year, we often struggle with the transition from winter to spring.

We are now facing, as an entire global community, a unique challenge and obstacle to this transition, and it is important to understand what this obstacle means and how you may be experiencing it through Yin-Yang imbalances.

Understanding Yin and Yang in Chinese Medicine

 The Taoist philosophy of Yin-Yang forms the basis for Chinese Medicine.  While many people have heard the term Yin-Yang and recognize its famous symbol, very few understand what Yin-Yang is, and even fewer people understand how this concept serves as the foundation for understanding health in both the macrocosm (world, universe) as well as the microcosm (the human body).  Yin-Yang was first referenced in the I Ching (Book of Changes), which scholars have dated to 700 BCE.

According to the philosophy of Yin-Yang, all phenomena are composed of two opposite, but mutually interconnected forces.  While Yin and Yang are opposites, they may only be understood in relationship to each other, and the balance between the two is constantly shifting in a cyclical manner.  For example, Yin is associated with darkness and night, while Yang is associated with lightness and daytime.  Since Yin and Yang are interdependent, one cannot exist without the other.  Daytime does not exist without nighttime and vice versa.  Yin and Yang also are mutually transformative; they are in a state of constant flux and each affects the other.  If one changes, the other follows.

As discussed, winter is the most Yin of all seasons, but even during the deepest part of winter, seeds are under the frozen soil preparing to burst forth in springtime.  Although Yin and Yang are continuously changing, the changes can be (and ideally are) harmonious or they can become imbalanced in a variety of ways.  These imbalances occur both in the macrocosm of the universe and the microcosm of the human body.

There are four main ways Yin and Yang can become imbalanced:

1)  Excess of Yin

2)  Excess of Yang

3)  Deficiency of Yin

4)  Deficiency of Yang

It is well beyond the scope of this article to go into depth about CM principles, but for the purposes of illustration, I am including the following about one way in which Yin-Yang imbalances manifest in the human body.

In the body, Yang concentrates in the head, and Yin concentrates in the lower body.  From a CM perspective, the pathology of headaches can be understood in one of the aforementioned four ways Yin and Yang can become imbalanced.  For example, headaches arising from an Excess of Yang are intense and throbbing.  Yang is hot relative to Yin, so an Excess Yang type of headache often is accompanied by a subjective feeling of heat, red face and eyes, and thirst.  Headaches that come from an Excess of Yin result from an accumulation of Yin in the head.  Excess Yin is cold, heavy, damp and slow to move, all of which combined block clear, healthy Yang from rising to the head.  A headache arising from Excess Yin is characterized by dull pain, heaviness of the head, blurred vision, and a feeling described by many of my patients as “brain fog.”  As you might imagine, the treatment strategy for a headache caused by Excess Yang is very different than the strategy for treating a headache caused by Excess Yin.

Yin-Yang In the Macrocosm

There’s one additional layer to include about Yin-Yang imbalances in order to tie the pieces of this article together and move into my theory of how and why we’ve reached this profoundly imbalanced moment.  Sometimes, what looks like a condition of Excess Yang in the body is actually a result of Deficient Yin leading to a rise into the head of unanchored Yang. Remember that the lower body is where Yin is concentrated and the upper body is where Yang gathers. Physiologically, Yin’s heavier nature in the lower body serves as an anchoring function for Yang. When Yin is sufficient, healthy Yang rises up in a slow, predictable and manageable way and enables a person to function with healthy energy throughout the day.  When Yin is too deficient to anchor Yang, then Yang will instead rise up in an uncontrolled way, which can lead to throbbing headaches, sudden rage episodes, or heat symptoms such as hot flashes.  The bottom line is that as a clinician, in order to accurately diagnose and treat a patient, I need to be able to assess both the state of Yin and Yang in a given person’s body at any given moment of time.

In “diagnosing” how we reached this moment of energetic mismatch between the Yang energy of Spring and the Yin imperative to hibernate (shelter-in-place), it feels important to reflect on how years of collectively depleting our Yin gave rise to a global experience of Excess Yang.  At its pinnacle, this state of Excess Yang in the macrocosm has given us (among other things) a viral pandemic.  The pandemic with its mandated hibernation has, in turn, provided many of us with the opportunity to build back into our lives the Yin attributes of introspection, stillness, and quiet as we sit—apart, and yet in this together.

Modern Industrialized Living Has Led to Macrocosmic Deficient Yin and Excess Yang

 It is important to acknowledge that how I’ve witnessed this phenomenon as a middle class, white, female, middle-aged professional in my long-time home of Washington, D.C might have limited relevance for some readers.  I write directly from experience as a former Washington insider (former State Department civil servant) and a clinician who has treated hundreds of people living within the paradigm of Deficient Yin-Excess Yang.  I realize that for those of you outside the Beltway, Washington, D.C. conjures up all kinds of images and ideas, for better and for worse.  However, I take the position here that the ways in which we live as residents of this city are mirrored in many other places around this country (and, for that matter, around much of the world).

I could write a whole book (and maybe I will someday) about how the ways in which we who inhabit modern, industrialized countries live, the systems we’ve built, and what we tend to value and prioritize have contributed to a deficiency of Yin and an excess of Yang in our own bodies as well as in the macrocosm.

First of all, most of us overwork (excess Yang) and hardly anybody gets enough rest (deficient Yin).  Many of my patients (especially younger, professional women) genuinely believe that it is impossible to slow down, to set boundaries with their bosses and colleagues.  Some of my patients even hide their chronic illnesses (including illnesses where their symptoms significantly worsen with stress) from their bosses because they are afraid this disclosure will affect their promotion potential.  I was one of these women for the ten years that I worked at the State Department.  I believed wholeheartedly that my entire worth was based on the tremendous things I might accomplish if only I worked harder and smarter. I was unable and unwilling to slow down even when I made myself sick with stress, anxiety, overwork and lack of rest.

I have the deepest compassion for my patients who are caught up in this cycle and see no way out of it.  Even after I permanently left the State Department to study Chinese Medicine and subsequently to start a busy clinical practice, I was all in.  Fortunately, a big part of my CM education was about learning how living in a state of Excess Yang (over-activity, insufficient quiet and rest) depletes Yin and lays the groundwork for all kind of imbalances that, if unaddressed, lead to numerous unpleasant symptoms and eventually chronic illnesses.  Over time and with many practices, I’ve learned to slow down my pace at work and outside of it and spend more time engaged in quiet, introspective activities that refill my Yin reserves.

Since I’m committed to being perfectly honest here, I need to disclose that I have struggled for a part of every single day since I closed my clinic about who I am and what my value is in the world without being able to do the work that I do.  This is true even as I’ve simultaneously loved slowing down, spending more time outside, spending hours per day in introspection of some form or another, cooking and eating slower meals, and laughing more with my husband and two sons.  My point here is that even though I am highly aware of my tendency to falsely conflate working/doing with my value in the world, some part of me still does this habitually.  So, I know (almost) all of you do the same to some degree or another.  And I have mercy on all of us because it is hard for us to disentangle what we do with who we are and with what we are worth.  It feels like we’ve been socialized since we were in the womb to make these false conflations.

If changing our habits around work and overactivity is difficult, changing our habits around consumption can seem insurmountable.  As a species, we over-consume (Excess Yang) and in so doing deplete our natural resources (leading to Deficient Yin).  Again, I count myself in the “royal we” lest anyone think that I am casting stones from my glass house. Our entire food system is set up for an overconsumption of our natural resources:  converting forest to farmland greatly increases greenhouse gas emissions; the use of water for irrigation can change river flows, reduce water quality and affect downstream ecosystems; overfishing depletes fish stocks and reduces the biodiversity of our oceans; and toxic substances (pesticides, hormones, antibiotics, and plastics) lead to contamination that affects air, water, and soil quality.

Many of us with resources travel frequently by car and air without spending much time thinking about the environmental impact of these trips or whether this travel is “essential.”  Whether we count ourselves among the rich, the middle-class or the poor, most of us have in our possession many things that we do not use or need,  If you’re like me, you might look around your house or inside of your closets and wonder how and why you’ve accumulated so much stuff over the years.

Finally, as much as I try to avoid using overused terminology, toxic masculinity is one of the most blatant signs of Excess Yang in our country and world.  When I use this terminology, I mean the toxic masculinity that led to the election of a self-professed sexual abuser to the highest office in the United States.  And I mean the toxic masculinity that has enabled powerful people to remain in power for years while perpetrating with impunity abuses of power against women, children, racial minorities, disabled populations, and immigrants.  I also mean the toxic masculinity that has led our government for *years* to prioritize spending billions of dollars on ineffective and unnecessary military toys instead of directing those funds to support the physical, mental and emotional needs of veterans—the human beings most affected by almost two decades of continual war.  (This is not even to mention how these dollars could be spent for improving the health, wellbeing, and educational systems for everyone.)  I also mean the toxic masculinity that has allowed our leaders to replace diplomacy, policymaking, and truth-telling with destruction of legal and ethical norms, bullying and lying.  I mean the widespread and long-term devaluation of the Yin/feminine qualities of nurturing, humility, stillness, introspection, listening deeply to one another and to messages from the earth.  And finally, our collective failure to adequately value the Yin quality of simply being rather than constantly doing.

What Now?

 I want to ensure that there is no confusion about what I am saying: both Yang and Yin are critical to the healthy functioning of the microcosm of our bodies and the macrocosm of the universe.  Healthy Yang (as opposed to Excess Yang) does exist; it emerges out of healthy Yin and is what makes taking action, transformation and growth possible.  It is not necessary for there to be a perfect balance of Yin and Yang in each moment (or ever).  In fact, this idea of perfect Yin-Yang balance is contrary to the natural Yin-Yang cycles in which, for example, Yin predominates at night and Yang during the day; Yin predominates in winter and Yang in summer.  But, since we as a species have overridden natural Yin-Yang cycles over the course of many decades, we are now living with the reality of unhealthy Excess Yang and Deficient Yin.  We are faced with many choices relating to how we might bring the Yin-Yang cycle into a better balance for the sake of our health, the well-being of the most vulnerable among us, and the health of our planet and future generations.

For all of the questions I am posing to myself these days, I have very few answers.  For once in my adult life, I am choosing to sit in the great unknown for an extended period of time—hours, days, weeks, months, longer—even when I experience profound discomfort, even when I am afraid, even while I am grieving.  For the first time, I am not taking much action beyond observing the springtime unfold, feeding myself and my family, reaching out to patients, friends, family member or reaching out to you all through these long (yes, I know they are LONG) written reflections.

My inner voice is whispering to me that very little of how I will be and what I will do in the world from this moment on will resemble the way I was being and doing before this pandemic forced me to stop.  This sitting and being rather than constantly doing feels both strange—especially in the springtime—and also very comforting.  My nervous system has slowed down.  I feel calm 90 percent of the time.  I am sleeping better than I have in years.  I’m able to observe and take in much more about what I and everyone I am in contact with needs and respond from a well-resourced place.  I am starting to understand my friends who tell me that they are able to communicate with trees and other parts of the natural world.  I have many visions and dreams about how I and all of us might come out of this scary and terrible-for-so-many period with new ways of existing in relationship to each other, our work, and our planet.

As one does in hibernation, I am allowing these visions and dreams to germinate under the metaphorically frozen ground and trusting that when the time is right, the decisions I make about what to do next will arise, like healthy Yang, from the wisdom contained so deeply inside me that I can only hear it if I stay still for long enough to listen.  I wish for all of you some version of this too:  more time in peace, reflection and stillness that will lead you to choices and actions that arise from having spent at least part of this long period of hibernation replenishing your Yin.