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January 4, 2011

The Shen - Clinically and Spiritually

Written by: Matthew Wagner, L.Ac., M.S.O.M.

Two fundamental aspects of shen exist; an esoteric and metaphysical interpretation of shen as the complement to Jing, fundamental to the pre-heaven essence and spirit, and an interpretation of shen as separated cognitive processes, or smaller shen, that together form the totality of the human intellect, sensorium, and conscious, sub-, or unconscious being, a larger shen. Neither of these two definitions are, of course, in and of themselves complete, but hang dependently upon one another. In this respect, what becomes vital to understanding shen, both spiritually and medicinally, is knowing how these two aspects of shen relate to one another. In other words, how do the philosophical implications of shen affect the clinical manifestations of shen? This understanding of both facets of shen is crucial to truly understanding the etiology of shen disturbance and to understanding the ramifications of pathologies of shen both psychosomatically and spiritually.

Philosophical Interpretation

According to Lonny S. Jarrett, in his book Nourishing Destiny, metaphysically, Shen is the Yang complement to Jing, arising in the formless Tao. It is that which illuminates the essence and manifests destiny, “our unique endowment from heaven, which, in turn, gives rise to our personal shen (heart spirit).” (Jarrett, 51).

All forms arise within emptiness, and ultimately return to emptiness. They arise temporarily and have no fundamentally separated nature of their own. Differentiation arises within the primordial void named Tao, thus giving rise to form. In this way, out of the Tao, or nothingness, arises the opposition and complementation of yin and yang. Yin and Yang manifest as the dynamic interplay of energies called the universe, or macrocosm, and further as the human condition, a microcosm arising within the macrocosm. Differentiation progresses from the dual aspect of opposites to the triple aspect of time, and so on, eventually resulting in the ten thousand things. Thus the arising of a single form within the formless Tao gives birth to myriad differentiation. And yet, in the end, all forms must reflect the emptiness from whence they came.

Indeed, the subsequent arising of form within form, as in the human condition (microcosm) within the physical universe (macrocosm), can be seen as the movement of differentiated form back to the Tao, as recognition of original nature, de, is only possible within the differentiated form of the human condition. Within the human condition there is the potential for recognition of the Tao, and thus, the potential that apparent duality may be realized as unity.

The Shen, in relation to form, is on the one hand the illuminating quality of realization, and “being in accordance with”, and on the other hand, is the motive force of the manifestation of the potential of jing. Simply put, it is the yang complement to yin, or in this case jing, and is dependant upon the jing for its substance, just as the jing is dependant upon the shen for its illumination.

In this way, shen manifests as the intangible light, or sparkle in someone’s eyes. As the “eyes are the window to the soul”, the shen reveals to what degree that soul is in accordance with “the way”. In terms of spirituality, the realization of one’s original nature, (in essence, the realization of the Tao), is wholly dependant upon the shen’s ability to illuminate the jing. This implies an inseparable unity between the two that exists on several different levels. On the one hand, there is the sense that there is a harmonious functioning of differentiated aspects, which, “remain pure and always reflect the underlying unity of the dao as it exists as truth in each person’s depths.” (Jarrett, 44). One the other hand, there is the sense that, in the greatest of alchemical transformations, these two separated aspects spontaneously unite as one, and this one is the very nameless Tao itself. At such point in time, “All of the illusory ideas and delusive thoughts accumulated up to the present will be exterminated, and when the time comes, internal and external will be spontaneously united.” (Sekida, 28).

Just as in the shen we see the real possibility for transformation and growth, we see also the potential for pathology, if the shen fails to illuminate the jing. The etiology of shen pathology on the spiritual level is the very same “illusory ideas and delusive thoughts” mentioned above. Jarrett calls this the, “false interpretation of reality and acquired belief systems that do not empower the manifestation of the true self.” (Jarrett, 42), and “the ‘mundane’ influences that dampen the fires of mingmen and extinguish heaven’s spark.” (Jarrett, 44). Thus, false interpretations obscure the light of shen and ultimately cause and are caused by the failure of a human being’s deeds, thoughts and actions to reflect his or her own heart. This obscurement of the Yang of the shen in turn leads to the pathogenic accumulation of yin, which may manifest clinically as dampness, phlegm, or other forms of accumulation, and spiritually as failure of the spirit to ascend.

Thus, viewing the shen clinically as it manifests in the five differentiated organ systems, and also as the totality of those systems, we must acknowledge that the brightness and health of these differentiated aspects of shen is ultimately dependant upon the quality and brightness of the pre-heaven shen from which it arises. At the same time, physiological and spiritual symptoms of shen pathology will overlap and occur simultaneously, and indeed, may be the same.

Clinical Interpretation

Clinically speaking, the shen is all of the mental/neurological functioning of a human being, both in part and in total. According to Maciocia, in, The Practice of Chinese Medicine, shen, “indicates the complex of all five mental-spiritual aspects of a human being,” (Maciocia, 198), this includes such mental functions as, “thinking, memory, consciousness, insight, cognition, sleep, intelligence, wisdom, and ideas.” (Maciocia, 198) Thus, pathologies that we see affecting the shen are pathologies of particular organ systems and the mental functioning that these organ systems govern.

When there is normal functioning of the shen, symptoms of shen disturbance in particular organ systems will not arise, and any pathological functioning of the organ can be seen as physiological in nature. However, when shen disturbance affects a particular organ one can expect to see a perversion of the natural psycho-emotional function of that organ.

For example, when functioning normally, the psycho-emotional expression of the liver is one of smooth flow, right action, and the appropriate use of force. However, when the shen of the liver is disturbed, we see a perversion of the liver’s psycho-emotional expression. Smooth flow becomes choppy, right action becomes inappropriate, and the just use of force and firmness gives way to anger and aggression.

This is true for shen disturbance of the other organ systems, as well, as in turn, the virtues, or appropriate functions are perverted into vices. The integrity of the spleen becomes worry and the inability to act, the wisdom of the kidneys becomes fear, etc. Just as the pre-heaven shen is obscured by “illusory ideas and delusive thoughts”, the shen of the individual organs are affected by the arising of inappropriate emotions. In truth, it can be said that an emotional response, disproportionate to the necessity of the situation it arises in response to, is itself an “illusory idea and delusive thought,” and is a hallmark sign of shen affectation.

This shen affectation, arising in the immaterial, can over time embed and manifest in the material, leading to actual physiologic impairment to individual organs and organ systems. In this way, chronic, intense grief at an early age may give rise to asthma, or acute, extreme joy may result in a heart attack. These emotions, in and of themselves, are not pathological, but, “become causes of disease only when they are excessive or prolonged or both.” (Maciocia, 209).

Furthermore, there is a complex interplay of causation between an organ and its shen, where pathologies in one both cause, and are caused by pathologies in another. This allows for the opposite scenario of material affectation affecting the immaterial. This occurs when the physiological impairment of an organ results in a disturbance of that organ’s shen. For example, just as shock and joy can scatter the Qi of the heart, “if Heart-Qi is deficient there is sadness, if it is in excess there is manic behavior.” (Maciocia, 210).

Lastly, as the shen also refers to the cognitive functions of the mind, shen disturbances include such pathologies as memory loss, insomnia, and creativity, to name but a few. Again, these cognitive functions are governed by particular organs and arise as a result of pathology of their respective organ systems.


The treatment of the shen can be both simple and complex depending upon the etiology of the shen disturbance. Most simply, it involves the restoration of the proper functioning of the organ affected, physiologically or energetically, which will naturally restore the proper functioning of that organ’s shen. This is true in such cases as spleen Qi deficiency leading to cloudy headedness and the inability to form clear thoughts, or heart yin deficiency leading to irritability and insomnia.

However, the treatment of shen in the “big picture” is by its very nature much more complex, and what may resolve a shen issue superficially may not actually address the root of the problem. This is not more true than for the emotions that color our lives, and the ideas and ideologies we structure them by.

As stated earlier, beyond the physiological implications and causes, shen disturbance is “the false interpretation of reality and acquired belief systems.” (Jarrett, 42). This implies that at the very core of what can be called shen disturbance, there is a fundamental self-deception. On the one hand, there exists a fantasy and dream of what reality is, both based upon preference and acquired from society. On the other hand there is reality itself. We see the contrast of a fixed model versus a fluid truth. When perceptions, wants, and desires are not supported by truth, pathogenic emotions arise. Clinically, shen disturbance leading to disease may be the result of organ imbalance. Spiritually shen disturbance leading to disease arises out of a lack of accordance with the way.

This, of course, makes for a very difficult treatment plan, especially as one must question: Why is there this lack of accordance with the way, and is a person really willing to do anything about it? Is a person really willing to look at their deepest beliefs of themselves and their world that may be making them ill, and further still, are they willing to actually affect a change? This raises some very serious questions for practitioners as well, namely: are practitioners clear enough in their own insight, are they themselves in accordance with the way, and can they effectively communicate with the patient the importance and relevance of looking at their own beliefs and experiences?

In treating the shen, as in all treatments, one must attack the disease as aggressively as the patient can support. Whether it is an actual physical disease or a destructive thought pattern, one can only effect change if there is support for that change. In the end this depends entirely upon the patient.


In the treatment of shen it is very important to recognize the relationship between our pre-heaven shen, the complement to our jing, and the shen of our organs, which make up our cognitive functions. As the organ shens derive from our pre-heaven shen, they mutually influence one another, creating an interdependency in which the health and vitality of the one depends upon the health and vitality of the other. This subtle relationship should always at least be considered, even if the health or interest of the patient excludes one from acting upon it. In the end, true health and quality of life can only be achieved with the recognition of the underlying balance of all energies.

Works Cited

Jarrett, Lonny S., Nourishing Destiny, The Inner Tradition of Chinese Medicine, Spirit Path Press, 1998. P. 42, 44, 51.

Maciocia, Giovanni, The Practice of Chinese Medicine, The Treatment of Diseases With the Use of Acupuncture and Chinese Herbs, Churchill Livingstone, 1994. P. 198, 209, 210.

Sekida, Katsuki, Two Zen Classics, the Mumonkan and Hekiganroku, 3rd. Ed. Weatherhill, Inc. 1996. P. 28.