Keys to a Deeper Understanding of the Emotions in Chinese Medicine

To come into a deep understanding of the emotional aspects of Chinese medicine, you have to start with the basics. In this article, I would like to demonstrate my understanding of the emotions as they are described in Chinese medical theory to provide some basis for further discussions on the topic.

There are a few preliminary things to understand before we dive into investigating the emotional states themselves. First, the emotions are associated with the five elemental phases, and thus the organs. There is some literature that lists seven emotions, but I have not investigated that yet. Second, each of the states listed below are like nodes. The physicians of Chinese antiquity were not so naive as to think that there were only five emotions! Each “emotion” is a keystone representative of a group of emotional states. This is the template used by most concepts in Chinese medicine. A concept like Qi, though often explained using a discreet definition, is a placeholder for a much larger and more complex group of phenomena.

One final preliminary note. Much literature about the emotions contains the following standard list: joy, anger, grief, worry and fear. You can find ample information about this list in a variety of books and websites. There are a variety of problems with this list, not least of which is the fact that it doesn’t make much sense to folks that joy could be a negative emotion as all the rest seem to be. In my first year, I learned an alternative way of looking at the emotions that shapes how I see them today. This alternative view sees both Yin and Yang sides to each of the five emotional states. The Yang emotional states are functional and an expression of balance, and the Yin sides are not. Below, I will describe each of these, beginning with the Yin as those are the most commonly discussed. Note that while the Yang “emotions” are natural responses to encounters with the world, the Yin “emotions” seem to be maladaptations.

The fire emotional state: Mania – kuáng 狂

I am not sure if this is the best character to use in this situation. In most lists of correspondences, the Yang emotion of Joy is listed, which I will discuss shortly. Kuáng has a range of meanings from manic, deranged, crazy to unrestrained and wild. The character consists of the dog radical on the left and the character for the Emperor on the right. Many times in class we have heard the Yin state of the fire organ systems associated with the image of the Emperor running around at night barking like a dog. I know I feel sort of this way when I’m fully in the grip of insomnia. It is worth noting that the Pericardium is associated with the dog – which connects it well with the Fire phase, and the Heart in particular.

More often you will see fire, and specifically the Heart, associated with Joy. Joy, the Yang emotion of fire, is represented in Chinese by two characters, lè 樂 and xǐ 喜. Le is variously translated as pleasure, happiness and enjoyment. The pictogram represents a musical instrument made of wood. Xi is translated as like, fondness and happiness and is created from a radical meaning mouth on the bottom and a radical representing a drum on the top. So both of these characters relate to music – a pleasurable activity that often brings people together. This is the kind of joy one gets from being around great friends, it is time in the summer sun filled with laughter and the building of beautiful memories. It is sharing of stories around the fire, playing group games, and the unabashed smile of a toddler.

As the Fire emotional state, it is associated with the Heart, Small Intestine, Pericardium and Triple Burner. Thus these organs are most buoyed when the Yang side of the fire emotional state is cultivated just as they are most harmed when the Yin emotional state takes hold.

As a nexus of emotional states, with the spectrum starting at Pure joy on the Yang side and going further and further off balance finally reaching Mania on the far Yin side this emotional state seems to speak to the outward and inward facing parts of ourselves. It concerns our ability to relate properly with other people, to let them into our world and to revel in the exchange of intimacy that takes place between people. A failure in this regard causes us to display behavior that tells other people to “keep away.”


The Earth emotional state: Worry – sī 思

The character for worry can also simply mean thought, to consider or to remember. So clearly in this situation we are to think about a superlative form of thought – “thinking something to death.” The character is composed of radical meaning “heart” on the bottom. Originally, the radical on the top was originally a picture of a brain but now it is stylized to the radical for “field” which is often associated with the Earth element. I like to use the ancient form when I’m trying to understand worry. When we think about it this way, in some sense, worry is literally putting your head OVER your heart! You could also think about it as thinking with your heart. The heart in your head?! This is why I love looking at the etymology of characters – even though I’m no expert I can find insight with just a few minutes’ research.

The Yang side of worry is simply contemplation, the physiological form of sī. Another word I like to use is chénsī 沉思 which is often translated as to ponder, or to contemplate. Contemplating what is to come, considering one’s place and the future – these are positive things. But taken too far they consume both Qi and Blood and subject you to a downward spiral of unhappiness.

As the Earth emotional state, worry/contemplation is associated with the Spleen and Stomach. A lot of people can attest to this – think about when you’ve been intensely worried about something – don’t you feel it in your gut? That churning feeling that only mental stress can inflict. We also know that hard thinking can’t be done on an empty stomach! In general, this nexus of emotional states seems to relate to our relationship with uncertainty. The world is an uncertain place, and in the best of cases we contemplate this – planning strategies to move forward. In the worst of cases we try to account for every contingency, worrying ourselves a hole in the ground.

The Metal emotional state: Grief – yōu 憂

Other translations for this character are sadness, mourning but also (interestingly) to worry or have anxiety. This perhaps simply shows the interconnectedness of the emotions but also might show us something about the special interdependence of Metal and Earth in the emotional life of human beings. The character is formed of a radical on the bottom that indicates walking, or walking slowly. Above that is the radical for heart and it is topped by a radical for head. So, grief can be thought of as a person who walks with their heart out. Sometimes I think about it as an emotional state where one’s heart has walked off with one’s head!

The Yang emotion associated with metal is detachment or individuation. Having a certain degree of detachment or indivdiuation is necessary for human beings to develop properly. We cannot always remain at our parents’ sides waiting for instruction. At some point we need to step back from what we were taught and find our own way. This can be a sad thing – thus its association with grief – but it is necessary. It’s also obvious how it is associated with Metal, and thus the Lung – since Lung is all about boundary and the surface. The other Metal organ, Large Intestine, is also connected to this emotional state. As a nexus of emotional states, the metal emotions seem to relate to our sense of boundary. When we open ourselves to others using the fire of the Heart to soften the sometimes rigid metal, we can become quite attached. When this willingness is seemingly betrayed by the loss of that person – we feel grief.

The Water emotional state: Terror – kǒng 恐

Kǒng can also mean fear or dread. Not such a wide range of meanings. 🙂 The character is composed of the Heart on the bottom (do we see a theme emerging?) and on the top a radical that means “to consolidate.” So fear is a consolidation, or constriction of the heart. One source indicates that the portion on the top originally meant “to embrace.” It is interesting to note that the Water phase is associated with cold and that one of the primary actions of cold in the body (and in nature) is to constrict, restrict and consolidate whatever it encounters. The Kidney, too, is said to require consolidation to retain the Jing essence.

The Yang emotional state of Water is that of conservation, or a feeling of wanting to preserve things. This is of course the most interesting when we relate it to the preservation of life. One of the most terror inducing situations is when our life or our loved ones’ lives are threatened. Overall, it is wise to want to preserve one’s health – to want to protect and preserve that which one has worked hard to create. We can also see the Yang effect of this in the desire to perpetuate ourselves through the creation of children – a Kidney related activity. This preserves the species as well as preserving those things we value in our family line. In a way, we can think of water’s emotional state as relating to our sense of the past and the future, or even our mortality.

The Wood emotional state: Rage – nù 怒

This Yin emotional state is often translated as “Anger” but as I don’t see anything wrong with appropriate anger, I thought translating it as “Rage” was more appropriate. While Anger can be in proportion and helpful in times when we feel frozen into inaction, Rage is probably never a good thing. The character nù is composed of the Heart radical on the bottom and a component meaning “slave” on the top. Interestingly, the slave radical is itself composed of the radical for woman on the left and that of hand on the right. Putting all of this together, we have the feeling in the Heart when a woman is forced by another’s hand. Or simply the emotion of a slave – which can only be one of rage toward the master.

The Yang side of this emotional state is initiative or motivation. As the wood emotion, it makes sense that it is what gets us going from inaction to action. I have begun to think of wood relating to those parts of our psychological life that relate to our work in the world – what we DO when we are doing. When healthy, we push through obstacles and achieve our dreams. When balance starts to waver, we become frustrated and begin to take this out on ourselves and others.


These are just some simple thoughts I have had in investigating the emotions in Chinese medicine. I’m sure many of you have your own ideas – I would love to hear about them in the comments.

I should point out that there are many people who have devloped or are developing theories about psychological/emotional health in Chinese medicine. As mentioned in a comment on a previous post, certainly one of the most respected is Dr. Leon Hammer, author of Dragon Rises, Red Bird Flies. Worsley-style five element acupuncture and its offshoots work with a robust model of the emotional and spiritual aspects of the human being.


About Eric Grey

Hi - I'm the founder of this site and the primary master of all functions here. When I'm not writing, you can find me reaching out to the Chinese Medicine community across the web and in my own backyard. I currently teach Chinese herbs at my alma mater, the National College of Natural Medicine. Additionally, I'm the founder of Watershed Wellness, a thriving local clinic in Southeast Portland in Oregon. No matter where I'm working, you'll find my focus on the Classical approach to Chinese medicine laced throughout everything I do.

View all posts by Eric Grey - Website: