amyjenner: September 16, 2019, 9:42pm
44 yr old attorney. CC insomnia 6-12 mos +7, migraines 6-12 mos +5, digestive issues (IBS type) 6-12 mos +5.
What happened 6-12 mos ago, you might ask? She was in a new job and the management was asking her to protect
a senior officer in the company with history of, and ongoing sexual harassment/ inappropriate conduct toward
female employees. She felt in a terrible bind because she didn’t feel she could just quit and tried to reason/work
with management. Obviously this is not only unethical and reprehensible but also illegal and it put her license to
practice at risk. She eventually sought council herself and was told to immediately go and collect her things and get
out of the building. Which she did.
She described it as being tremendously stressful.
She is a nervous, anxious person (subj. and obj.). Medium build, a little on the heavy side.
insomnia +8, up 2-3 hours every night
Migraines +5 stress induced, around lft eye, affects vision
IBS +5 stress induced, she has managed alternating diarrhea/constipation since childhood
Neck and shoulder tightness/pain +5
Menstrual difficulty 0
grinds teeth => jaw pain +6
symmetry +1
medial heal dry +6
skin: norm, dry in winter (in maine)
thenar eminence +3 flat
varicosities none
overweight +3
hand and feet cold (warm to the touch)
temp: prefers cold weather +5
abdomen: warm, tight rib side and rectus, oketsu
tongue: violet +7, distended sublinguals +4
It seemed fairly straight forward. GBxs, SJxs (too polite to quit). I decided on PC+r.
She was really freaked out about the thought of the needles sitting in her skin so it was a little difficult to determine
what was going on. She started to feel anxious and afraid. Obviously an adverse reaction. Removed needles. With
all GBxs sx there was no way I was going to counter that with GB+. I then thought to ask if while the work
situation was going on if she felt afraid. She said she was terrified. Sooo, I put in HT+. She said she felt calm and
relaxed and she drifted off to sleep.
So, emotionally the situation was terrifying, but she is a warm person who prefers cool/cold weather. To me the
most glaring things are the GBxs, SJxs, Kid xs (bld stag), on the damp dry scale, I would go with LUxs.
I’m not sure where to go from here… maybe another HT+ or maybe we could do the PC+ next time. Not sure how
I would tell. She doesn’t seem to have a lot of self awareness in that she seems to habitually override her body’s
signals and drives herself forward based on what she thinks she is supposed to do.
Anyway, would appreciate your thoughts and ideas my dear fellow Sa’am-sters
Joanne_Tait: September 16, 2019, 10:29pm
30/01/2024, 13:28Fooled by the story – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/fooled-by-the-story/613/print3/7
That’s so interesting. I would try tonifying liver on the right. I think she could use some shielding from the whole
situation too. May help the migraines and the sleep. Plus the slightly cooling aspect seems relevant for her too. It’s
also a very easy treatment needle wise.
Ryan_Gallagher: September 16, 2019, 11:15pm
Hi Amy, Sounds like you made a wise adjustment! I’m wondering what you think about supplementing LI for this
patient; she’s overweight and warm. Does her anxiety seem like the Spleen type—stuck in the mud and spinning
the wheels, ruminating. Could dampness be the underlying pathology? If it is, then when cold fear arises, the boggy
terrain freezes, causing pain (migraine). So, supplementing HT is more of a branch treatment and supplementing LI
would be a bit deeper. Just a thought.
KristinWisgirda: September 16, 2019, 11:24pm
Thanks for the interesting case Amy.
I am with Joanne for considering Liv+ as a next step. Her presentation at the next visit might have changed or you
might get a deeper sense of her to guide you.
Her SI/K balance isn’t straightforward K excess to me. The tongue has the only definitive Saam signs of blood
stasis. 0 Menstrual difficulties, varicosities none, symmetry +, medial heel dry +6 points to some SI excess too. I
mention this to put K+ on the table.
The adverse reaction to P+ is super informative. It makes me wonder if GB+ will be just what she needs after
stabilizing the foundation of her other channels, given her situation.
I hope she keeps seeing you for her sake and for ours so we find out how she makes out with treatment. Please
keep us updated.
amyjenner: September 18, 2019, 4:03pm
I will ask further into the rumination idea. The feeling being with her is more that her hair is standing on end and
she is trying to act cool and grownup.
I like the idea of Liv+ for the next time I see her. Will keep you posted
KristinWisgirda: September 18, 2019, 4:38pm
30/01/2024, 13:28Fooled by the story – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/fooled-by-the-story/613/print4/7
amyjenner:
The feeling being with her is more that her hair is standing on end and she is trying to act cool and grownup.
Thanks for this impression. This case stuck with me. I was wondering how it felt to be around her given her
negative reaction to P+ and positive reaction H+. The hair standing on end sounds like a terrified freeze response. I
wonder if there was any other indication of hypofunctioning of UB excess under the veneer of trying to play
grownup.
How much of the bad reaction to P+ was a system relying on GB energy trying to protect it in the only way it knew
how? I’ve seen GB play that role in other situations too, for example irrational irritability when one is overtired.
This case reminds me that it is helpful to discern what is true and what might be a compensation.
The warm love of a healthy Heart helps one feel connected and safe too.
amyjenner: September 18, 2019, 5:44pm
when the negative reaction to PC+ was happening, the big tell was that her lip was trembling and she looked like a
child. She didn’t say anything till I asked what was going on. She said she felt anxious and afraid. I was trying to
parse out her fear of the needles vs a treatment reaction and let it sit for another minute to be sure it was wrong
treatment.
I went for the heart with the idea that the events were traumatic and that her response to it was terror.
amyjenner: September 18, 2019, 5:46pm
KristinWisgirda:
How much of the bad reaction to P+ was a system relying on GB energy trying to protect it in the only way it
knew how?
I don’t really understand what you mean by this? Is it that perhaps the GB is so taxed that when I pulled on it with
PC+ there wasn’t anything available?
amyjenner: September 18, 2019, 5:49pm
KristinWisgirda:
I wonder if there was any other indication of hypofunctioning of UB excess under the veneer of trying to play30/01/2024, 13:28Fooled by the story – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/fooled-by-the-story/613/print5/7
grownup.
I’ll have to check this out. My feeling is that there is a lot of anxiety going on under the cool appearing exterior.
Hard to know if that is a hypo or a hyper situation at this point.
Is that what you meant?
KristinWisgirda: September 18, 2019, 8:06pm
These are just my attempts to try to figure out what happened here and maybe get a deeper understanding of the
channels in the process. Take it all as my musings, not Saam doctrine.
amyjenner:
My feeling is that there is a lot of anxiety going on under the cool appearing exterior. Hard to know if that is a
hypo or a hyper situation at this point.
Is that what you meant?
If H+ helped, then there must have been a UB excess of ice cold fear for it to counterbalance. Toby characterizes H
excess as hyperactive in contrast to UB excess hypoactivity, in extreme curling up in a ball or playing dead.
Reflecting back, did this patient present with any other UB excess kinds of signs before the frozen silent lip
trembling?
amyjenner:
She doesn’t seem to have a lot of self awareness in that she seems to habitually override her body’s signals and
drives herself forward based on what she thinks she is supposed to do.
Maybe this impression was a sign of a relative P excess, enough rational “good girl” behavior to dissociate at
times.
Here’s a theory: The patient needed to feel safe in a very threatening environment. Her Heart energy was low (UB
excess) but her P and her GB energy were intact enough to try to create a sense of safety in their respective ways:
the P with good girl grown up behavior and the GB by keeping her vigilant at night and disturbing her sleep.
The intact GB energy might have been upset with the apparent threat of needles that wasn’t really solving the issue
of UB excess fear. Abundant Gb can also kick back or fight a P+ treatment.
Anyhow the GB excess symptoms are a compensation, an effort by the body to protect itself, however
ineffectually. An injured animal might lash out as you approach it. Though a P+ treatment might calm, the animal
would really be better served by treating the injury, whatever that is.30/01/2024, 13:28Fooled by the story – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/fooled-by-the-story/613/print6/7
amyjenner: September 18, 2019, 10:40pm
I appreciate the musings. Would you say a little more about the idea that abundant GB can kick back PC treatment?
KristinWisgirda: September 19, 2019, 12:02am
amyjenner:
Would you say a little more about the idea that abundant GB can kick back PC treatment?
There was a case in Tucson with obvious Gb excess- very emotionally labile. Toby treated P+. The patient didn’t
settle initially but he let her ride it out. She was “fighting the treatment.” By the end she had settled and was much
calmer. He said if it wasn’t a class setting, he might have switched and treated UB+ instead to calm her down with
ice water but felt that UB+ would be riskier based on other aspects of her presentation.
amyjenner: September 19, 2019, 5:39pm
so, would GB be the only one who “fights” the treatment or will you find that in other counterbalance pairs?
KristinWisgirda: September 19, 2019, 5:58pm
SJ excess can be very controlling. T said that this might have been part of the above patient’s resistance. So a
Shaoyang combo kicking back.
amyjenner: September 27, 2019, 11:23pm
Saw her again today. Her anxiety has been pretty high, +7. There but not panic. She noticed she is worried about
going to bed bec. she might not sleep. She was away for work much of this week and sleeping alone in a hotel in
Boston so not a good measure of progress. I did Liv+ rt. she relaxed and rested deeply. I’ll see her next week.
RMcMahon: December 23, 2019, 1:24am
30/01/2024, 13:28Fooled by the story – Sa’am Clinical Insights – Qiological Community
https://forum.qiological.com/t/fooled-by-the-story/613/print7/7
Is there any update on this interesting case?
amyjenner: December 23, 2019, 11:08am
No, sadly. I think she got too freaked out and discontinued treatment. I only saw her the 2 times.