Autism is an insidious disorder that affects 1
in 88 children.1 While there is no known cure, more and more evidence indicates massage and acupressure can significantly improve the autistic child’s quality of life.
Officially, autism is called autistic spectrum disorder (ASD) and is categorized as a neurodevelopmental behavior disorder. It is characterized by an early onset of lack of attachment and an almost complete disassociation with the environment.
Autistic children and adults display varying degrees of tactile defensive behaviors, and when touched, may react aggressively. Research has shown that when the tactile system is not working properly, abnormal neural impulses are sent to the cortex of the brain, where they can interfere with other brain processes. This type of overstimulation in the brain can make it difficult for an individual to organize his or her behavior and may lead to a negative emotional response to touch.2
Though most experts believe the origin of this disorder is in the brain, recent clinical studies have revealed a strong gastrointestinal connection to ASD as well. Mild to moderate degrees of inflammation and decreased digestive enzyme activity were found in the upper and lower intestinal tract of autistic study subjects.3 In addition, some experts suggest that autism is an autoimmune disorder, while others propose that it originates from a virus. With all of the conflicting points of view, it makes sense to consider a holistic model when attempting to address ASD.
TCM Traditions
In understanding how acupressure might help the autistic child, let’s first take a look at the principles of traditional Chinese medicine (TCM). According to TCM theory, the body has six yang meridians that converge on the head which provide communication and coordination of brain activities with other parts of the body. The six meridians are the Triple Burner, Gallbladder, Urinary Bladder, Large Intestine, Small Intestine, and Stomach (Head Meridians & Acupressure Points, page 85). It is believed that any disorders along any of these meridians have the potential to affect the development of the brain. Conversely, any disorder of the brain could affect these meridians and, therefore, the organs they feed.
In addition, these meridians also connect and re-energize the three burners, or energy centers, located in the head, chest, and belly, which are the energy sources for the entire body. The Upper Burner refers to the upper part of the body and is comprised of the heart, lungs, and pericardium.
The Middle Burner is related to the spleen, which, according to Western medicine, has enormous immunological functions after birth. In TCM, however, the spleen metabolizes and transports the nutritious qi (also known as universal life energy) from food and drink to the rest of the body after the stomach has broken it down. Accordingly, the spleen assimilates usable nutrients from food and drink and builds up physical strength and vitality in the body. Entire schools of Chinese medicine were founded in past centuries around the study and treatment of the spleen.
The Lower Burner refers to the lower section of the body and includes the small and large intestines, kidneys, and urinary bladder.
The Flow of Energy
In TCM, the practitioner is focused on how and where energy circulates. The pattern of energy flow in a healthy person is as follows: energy flows out the top of the head and down the outside of the body along the yang meridians to the feet, and up again inside of the body along the yin meridians to renew the three energy sources, or Triple Burners.
The meridians along the head create and support mental growth, the meridians along the chest are responsible for social and emotional growth, and those in the belly area create and support physical growth. Growth depends on the free and abundant circulation of blood, which is moved by qi. Any blockage of qi will cause circulation to slow down and even stop. This, in turn, will impede mental health, resulting in cognitive delay and also delayed development of social skills.
How can a blockage of qi in one single meridian, or even a small part of the body, have such comprehensive effects? The answer lies in the fact that all the 12 main meridians and their branches form an interconnected whole that transmits energy to every physiological system, organ, tissue, and cell. One can liken the interconnectedness of all meridians to a spider’s web. Any tension or slack in one section is almost immediately felt in other sections.
Making Connections
In 2010, acupuncture physician Shui Yin Lo made a thermographic, or infrared, study of the six yang meridians that converge on the head in order to find out which meridians were truly involved in autism.4 In the autistic children studied, results showed energy concentrations in the form of heat along three yang meridians, and hot spots that concentrated around the acupressure points on these meridians. The concentrations of heat indicated areas of inflammation in the tissues through which these meridians traversed. The meridians with the most inflammation were the Urinary Bladder, Gallbladder, and Stomach. All of these meridians originate on the head and face. From an anatomical viewpoint, Yin Lo revealed that most hot spots and meridian lines of inflammation ran along the side of the head and front of the face, and crossed the thyroid gland and armpits.
In the study, the subjects’ armpit lymph nodes were swollen, probably as a result of an overactive immune system. The findings of these thermographic studies, though, had to be correlated to signs and symptoms, according to TCM theory, for a more complete picture. By themselves, they were too nonspecific.
The clear inflammation of the three yang meridians indicated a dysfunction in the corresponding physiological systems traversed by these meridians: the gastrointestinal and immunological systems, influenced by the Gallbladder and Stomach meridians (this is consistent with research that suggests a correlation between autism and the gastrointestinal system), and the neurological system, influenced by the Urinary Bladder meridian. What is more, all three yang meridians originate in the head, which means that the inflammation is also likely a reflection of dysfunction in the brain, or neurological overstimulation.
Yin and Yang
Before going further, it is necessary to briefly summarize the differences between yin and yang as they relate to the body. Yin refers to the anatomical aspects of the body, like the skeletal and muscular system, whereas yang refers to the functional aspects, or physiology, of those anatomical systems. From a bioenergetic viewpoint, yin refers to what is fixed, stable, and static; yang refers to what is changing, functional, and moving. The two aspects are complementary and not mutually exclusive.
Looking further through this lens at the three systems most impacted by inflammation gives us better perspective. For example, the Urinary Bladder is in charge of the autonomic nervous system, which means it also controls the sympathetic and parasympathetic nervous systems. Applying TCM’s Five-Element Theory, we see that the Urinary Bladder’s earth element is Water. An imbalance in the Urinary Bladder caused by excess energy in Wood results in the person being fearful, inflexible, opinionated, and suspicious. Conversely, a deficiency in energy will result in cynicism, feelings of isolation, and lethargy.
The Gallbladder is attributed with courage and initiates change and movement according to its element Wood. An imbalance in the Gallbladder organ caused by weakness results in easy discouragement by slight adversity, indecisiveness, and timidity. In excess, this energy leads to self-opinionated, tyrannical, and uncompromising behavior. When the organ is in balance, it enables change, movement, excitement, and warming. These are typical yang characteristics overall.
The Stomach is in charge of the breakdown of food and water. Its element is Earth. An imbalance in the Stomach caused by excess energy will excite the mind and cause mental symptoms like confusion, hyperactivity, mania, and severe anxiety. Also, from a Wood energy perspective, the person becomes meddlesome, overprotective, and worried. If the Earth energy is weak, the person becomes vacillating and hungry for attention and love. On a physical level, the Stomach is also responsible for providing energy to all systems from food and drink. In coordination with the Spleen energy, it transports this energy to the lungs and combines with Air energy or qi as well.
Treating the Whole Client
In keeping with TCM philosophy of treating the client as a whole, the gastrointestinal, immunological, and neurological systems should all be treated together with the autistic client. For the massage practitioner, one way of assessing a dysfunction in the meridians is by testing for sensitivity of the acupressure points and meridians themselves. High sensitivity usually indicates major imbalances. According to the thermographic studies by Yin Lo, the following meridian points showed hot spots in autistic patients:
On the Gallbladder (GB) Meridian bilaterally—GB 1, 2, 3, and 15. These run along the side of the head and above the ear. GB 22 also showed heat signs.
On the Urinary Bladder (UB) Meridian bilaterally—The hot spots ran along UB 37 to UB 40, which lie on the back of the legs and hamstrings.
Lastly, on the Stomach (St) Meridian—heat ran from St 1 to St 4, which run from below the eye down the front of the face. The Stomach Meridian also runs through the thyroid, which showed inflammation in Yin Lo’s study subjects all the way to St 12 on either side of the chest below the clavicle.
Treatment Strategy
A strategy for working with autistic clients is to treat all three suspect meridians together. The massage therapist will use a combination of tui na and manual lymphatic massage. Acupressure should generally be applied with pressure equaling the weight of a nickel. Again, the three meridians represent a treatment of the neurological, gastrointestinal, and immunological systems.
In addition, for balance, some of the yin organs and meridians that partner with the yang organs—according to the Five-Element Theory—shall also be addressed.
Start with the Stomach meridian and its Five-Element partner, the Spleen, by doing a Chinese tui na stomach massage (Image 1, page 86). The goal is to balance and harmonize Stomach qi. This treatment involves a mixture of rotations, kneading, and squeezing with both hands, combined with acupressure using fingers and thumbs.
From a Western viewpoint, this facilitates better food breakdown and assimilation. In addition, certain acupressure points like St 36 (Image 2), the master point of digestion, should be addressed on each leg. If it’s tender, which is likely to happen in conditions of excess, the therapist should rotate his or her thumb counterclockwise with the pressure of one nickel until the sensitivity stops. This can take a minute or two; exercise patience.
In addition, the Lower He-Sea points of the Large and Small Intestines, St 37 and St 39, can be addressed as part of treating vital organs of digestion.
To finish the stomach treatment, a connection can be made by holding two contact areas and points. The extra point between the eyebrows, Yin Tang (popularly known as the Third Eye), functions also to calm the mind and Conception Vessel 12 (CV 12) on the mid-sagittal line between the navel and xiphoid process. CV 12 is the master point of the stomach (Image 3). Contact can be static for 15–20 seconds, followed by counterclockwise rotation of the Yin Tang point.
After treating the stomach and its corresponding meridian, the Kidney meridian can be addressed for more sedation and grounding. In TCM, the excess energy of the organs and meridians along the head can be likened to a fire going out of control. The nature of heat energy is to rise, so it tends to rise to the head and stay there. Also, the brain is controlled by the Heart organ, which, from a bioenergetic viewpoint, belongs to the element Fire. So, by using the Kidney organ and meridian points belonging to the Water element, we douse that fire, in a manner of speaking. Two good points to treat with acupressure are Kidney 1 and 3 on the foot. After holding each point for approximately a minute, the therapist can rotate each thumb counterclockwise for another minute or so with light pressure.
So far, we have not started locally on the inflamed points on the head, face, and thorax. The idea is to first work distally to these areas to pull the excess energy away from the brain, which results in grounding and sedation.
The last step is to do acupressure on the head itself by focusing on the three yang meridians in sequence. The objective is to channel the excess energy in the meridians of the head downward. When a child is upset, qi energy builds up in the head. According to various studies, autistic patients often overreact emotionally to sensory stimuli, or become frustrated by not being able to communicate in an intelligible manner or at all. First, one should do a “Crown-Pull,” which pulls all negative energy down, away from the head. With the client supine, place four fingers on the forehead and pull along the sides of the head toward the table. In doing so, qi energy is unblocked and drawn along the main channels.
Then, focus on the Governor Vessel (GV), since it rules the yang qi in all yang meridians and organs in the body. It is closely linked to the brain, spinal cord, and kidneys. Since it communicates with the brain, it performs a similar function to the pituitary and adrenal axis link. Start acupressure from the hairline on top of the forehead and work backward, holding each point from GV 24 to GV 20 for about 15–20 seconds each. This should be repeated 10 times. Special attention should be given to GV 20, as this point is used for all kinds of pain and mental disorders, including anger alternating with joy, apoplexy, cerebrovascular disorders, chronic convulsions in children, mania, schizophrenia, seizures of all kinds, and shock. It is also used for headaches, as well as pain and inflammation in the head. Linger for about 30 seconds each time on this point, using a combination of static light pressure and counterclockwise rotation for grounding.
Next, parallel to the Governor Vessel is the Urinary Bladder meridian (UB). Apply acupressure starting from UB 2 on the medial extremity of the eyebrow all the way back to UB 10 in the depression under the occiput and in the lateral aspect of the upper trapezius.
Finally, on the head, acupressure should
be applied to the Gallbladder meridian points from GB 1 in the outer canthus to GB 15 above the ear.
Lymphatic massage strokes should be applied to the area of GB 22 under the armpit to relieve a burdened immune system. To enhance the immune system, return to St 36, the master point of the digestive system and Middle Burner. Treatment strategy is one of sedation—grounding first and then tonifying and fortifying the system. Again, if there is sensitivity, rotate with your thumb counterclockwise for sedation and grounding. Then, follow up with clockwise rotation of both points for strengthening.
Balance and Harmony
The overall effect of an acupressure and massage treatment is balance and harmony, where the client can become centered and grounded in a holistic manner. The body-mind-spirit connection, integral to holistic medicine, should be reestablished and strengthened, so that the client can be present in the moment with all of his or her senses. Western research has established how complex autism is, with its involvement of many physiological systems. Working with the autistic client’s gastrointestinal, immunological, and neurological systems is in keeping with traditional TCM philosophy, where balance and harmony are achieved by treating the client as a whole.
Notes
1. Centers for Disease Control and Prevention, “Facts About ASDs,” accessed August 2013, www.cdc.gov/ncbddd/autism/facts.html.
2. Autism Research Institute, “Sensory Integration,” accessed August 2013, http://legacy.autism.com/families/therapy/si.htm.
3. Karoly Horvath, “Autism and Gastrointestinal Symptoms,” Current Gastrointestinal Reports 4 (2002): 251–58.
4. Shui Yin Lo, “Diagnosis, Treatment, and Prevention of Autism via Meridian Theory,” American Journal of Chinese Medicine 40, no. 1 (2012): 39–56.
Wolfgang Luckmann, AP, LMT, Dip. Hom., is a licensed acupuncturist and massage therapist based in Fernandina Beach, Florida. He is also a continuing education provider for massage and acupuncture and teaches more than a dozen courses across the country. For more information, visit www.wolfgangluckmann.com.
Resources
Fu, W. Chinese Tui-Na Therapy. Beijing: Foreign Languages Press, 1994.
Kaputchuk, T. The Web that Has No Weaver. New York: McGraw-Hill, 1994.
Lee, M. Insights of a Senior Acupuncturist. Boulder, Colorado: Blue Poppy Press, 1992.
Tan, R. Dr. Tan’s Strategy of Twelve Magical Points. San Diego: Richard Tan, 2003.
Xinnong, C. Chinese Acupuncture and Moxibustion. 3rd ed. Beijing: Foreign Languages Press, 2011.
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