In this post, I will discuss various acupuncture points for anxiety and compare TCM protocols to Master Tung's methods. Also included in this post is a discussion of ear acupuncture points and their relation to the vagus nerve, breathing techniques, and how to use touch, acupressure, and tapping for anxiety.
Some of the most common TCM acupuncture points for anxiety include:
Yin Tang
HT 7
PC 6
SP 6
LV 3
LI 4
Comparing the most frequently used TCM points for anxiety to Master Tung's points we find many similarities. For instance, the Tung system uses Ling Gu rather than LI 4, while LV 2 and LV 3 (66.03, 66.04) are used in unison. Rather than using PC 6, the Tung system may use a three-point unit consisting of PC 4, PC 5, and PC 7. (1)
To comprehend the logic of the Tung system it helps to understand two things.
The first is to recognize that many of the points are not much different than TCM points and are located on the 12 regular meridians. Many of the locations only vary by 0.5 - 1 cun from the traditional TCM acupuncture points and are located between or near standard TCM points. These little shifts in location can often produce stronger results, and anyone who uses Ling Gu (22.05) rather than LI 4 understands that Ling Gu produces more pronounced therapeutic outcomes. Ling Gu is halfway between LI 4 and LI 5 and about 1 cun proximal to LI 4, it is located immediately at the junction where the first and second metacarpal bones meet. Similarly, 66.04 is 0.5 cun proximal to LV 3 and at the junction of the 1st and 2nd metatarsals, it also tends to have stronger and more wide-ranging benefits than Liver 3.
The second major thing to understand about Master Tung's methods is that points are used in two or three-point units called dao ma's. So, rather than just needling LV 3, the Tung system will needle both LV 2 and LV 3 as a unit. Similarly, rather than only needling PC 6 on the pericardium meridian, a unit consisting of PC 4, PC 5, and PC 7 may be used. I have also found that PC 4 and PC 6 will produce similar results. This method of using two or three points in close proximity and on the same meridian produces a synergetic effect.
The Jue Yin Meridians for Anxiety
Liver and pericardium points are often used for treating anxiety, with PC 6 and LV 3 being some of the best TCM acupuncture points for anxiety. In the Tung system, Heart Three Needles (PC 4, PC 5, PC 7) and 66.03 and 66.04 (LV 2 & LV 3) could be used instead of just PC 6 and LV 3. A powerful point combination using Tung style methods would use PC 4, PC 5, and PC 7 on one side, and LV 2 and LV 3 on the opposite side. This five-point prescription may even be enough for some clients, especially if they are needle-sensitive.
From a TCM perspective, the liver and heart/pericardium are usually involved in anxiety. Patterns like liver qi stagnation, liver yang rising, liver fire, heart fire, and blood deficiency can all be addressed with the liver and pericardium points, regardless of the exact pattern that is present.
The Jue Ying - Yang Ming Connection
In a meridian systems approach, such as used in the Balance Method and Master Tung style acupuncture, the jue yin and yang ming meridians are often used together. In the above diagram, we see that the yang ming meridians can also be used in the treatment. Ling Gu and LI 4 are recognized in both systems as being useful for anxiety, and stomach meridian points may be used for anxiety, especially in cases with qi or blood deficiency, or if phlegm is misting the heart orifice (Stomach 36 and Stomach 40).
The Four Flowers (77.08, 77.09, 77.11)
The Four Flowers are some of Master Tung's points which are similar to ST 36, ST 37, and ST 38. Rather, than being located in the tibialis anterior muscles, they are located directly adjacent to the tibia, in the space between the bone and muscle. They are needled as a three-point unit, but if the patient is overly sensitive to needles, two points may also be sufficient.
The point combination in the diagram above also covers most of the TCM patterns for anxiety including liver patterns, liver overacting on the spleen and stomach, blood deficiency, blood stagnation, fire, etc. (If excessive heat or fire was present in a patient I would also add SJ 5 to the same side that I needle Ling Gu/LI 4.)
In the Balance Method and Tung style treatments, we usually don't needle the same points bilaterally. This has the advantage of reaching a more diverse number of meridians, myofascial lines, and point groups. Some research has indicated that bilateral needling for heart conditions does not give any additional benefits over needling points on one side. (2)
Heart 7 and Lung 7 for Anxiety
The acupuncture point HT 7 is also commonly used for anxiety, and some sources will include LU 7, especially if grief is a part of the patient's anxiety pattern. People who suffer a terrible loss will experience grief, and this can also be accompanied by anxiety. The pain of losing a loved one, or something significant in one's life, often induces not only grief but also fear. In 5-element terms, we can think of this as a metal (grief) pattern engendering water (fear). This pattern is common when a significant other has passed away and left the person alone; however, other substantial losses in life can also lead to grief that engenders fear and anxiety. For these reasons, we may also want to use Heart 7 or Lung 7.
A powerful dao ma can also be created using HT 7, LU 7, and either PC 7, PC 6, or PC 5. Any of the PC points may be chosen, and only one needs to be selected when using it with HT 7 and LU 7. I tend to use PC 7 or PC 5 more than PC 6 for this combination. This dao ma should only be used on patients who are not overly needle-sensitive. For patients with anxiety, we need to be careful to not overstimulate them with needles or we could induce a sympathetic response which will aggravate the anxiety; in these clients, needling needs to be done in a way to induce parasympathetic responses to calm the nervous system. This is something I covered extensively in my acupuncture course discussing how stress and trauma responses affect the autonomic nervous system.
Ear Acupuncture Points for Anxiety
Ear points may also be used for anxiety, and the ear presents some special opportunities to calm the mind and body by stimulating the vagus nerve. The vagus nerve is the primary nerve that regulates the parasympathetic nervous system, and various studies show promising results when using ear acupuncture points for anxiety and other conditions involving the vagus nerve and ANS. (3)
The vagus nerve is accessible through the ear as it innervates the concha which can be seen in the red area in the image below.
Ear points in the concha that may be used for anxiety include Point Zero, Kidneys, Liver, and Heart. From a neurological perspective, any of the points in the concha will modulate the vagus nerve, and in my experience, I find it useful to needle or apply ear seeds to three points in the concha. Like a dao ma, three points in the concha provide strong enough stimulation and produce a synergistic effect.
Other ear acupuncture points used for anxiety that are not in the concha include Anxiety Point, Limbic System Points, and Ear Shen Men. (3) These points are noted as white dots in the image below.
The points associated with the limbic system like the cingulate gyrus, amygdala, hippocampus, and the anxiety point are located inferior to the antitragus and inter-tragic notch. While this region is largely innervated by the great auricular nerve, the vagus nerve is also distributed through this region as well. The image below depicts a more accurate view of nerve distribution in the ear, and in this image, the vagus nerve is represented in green. The presence of the vagus nerve in these regions likely plays a role in the ability of these points to calm the mind and reduce anxiety.
Supplemental Methods for Treating Anxiety with Acupuncture
There are several other techniques I use when treating anxiety that combine well with acupuncture and help to amplify the effects. One of the most easiest and practical methods is to teach the patient to extend their exhalations and make them twice as long as their inhalation. Doing this stimulates the parasympathetic system and quickly induces relaxation. When practicing this, they should not strain, and breathe in at their natural rate while counting to two or three. When they exhale have them increase the count so that they are exhaling for a count of three or six. Simply extending the exhalation has fast physiological effects and can be very calming.
For needle-sensitive patients receiving acupuncture for anxiety, I sometimes start with only the hand and arm points such as Ling Gu/LI 4 and the pericardium points. After this, I will massage their feet and this is deeply relaxing for many people. Massaging the feet also activates the S3 myotome, and can help to induce a deeply restful craniosacral response. The craniosacral system is a physiological connection between the cranial nerves, limbic system, and sacrum. Craniosacral therapy will access this system, but it is also accessible to acupuncturists when they create point combinations accordingly. I have developed a 5-hour class on this subject and you can read more about that at this link - craniosacral and acupuncture.
Tapping and EFT for Anxiety
Tapping is a remarkably effective and simple system to use for anxiety. Like acupuncture for anxiety, tapping stimulates various points and combines acupressure with simple statements acknowledging and accepting the anxiety. While tapping on the acupressure points, statements are made that have healing effects.
The standard statement we start with in EFT and tapping is called the setup statement and acknowledges the problem the patient has. For someone with anxiety, they can simply say, "Even though I have this anxiety."
The acknowledgment statement immediately follows the setup statement and starts by saying, "I deeply and completely accept myself."
When tapping for anxiety, the whole statement is, "Even though I have this anxiety, I deeply and completely accept myself." This statement is repeated by tapping a sequence of acupressure points. These statements may also change and evolve as the process continues, and there are immense advantages to allowing the statements to change naturally. For instance, tapping has a unique way of uncovering unconscious thoughts, feelings, and memories, and when these are added to the setup and acknowledgment statements many therapeutic results can be achieved.
The sequence of acupressure points used in tapping include:
SI 3
UB 2
Tai Yang
ST 3
DU 26
CV 24
ST 11
GB 24
DU 20
Notice that several of these acupuncture points are also used for anxiety including Tai Yang and DU 20. Since many of these points are located on the head and face, they likely influence the trigeminal nerve which also has direct connections to the limbic system. Research on tapping seems to indicate that it can change neurological activity in the amygdala, and given tapping's positive effects on anxiety, depression, trauma, and other psychological conditions, it is feasible that it is affecting the limbic system.
Summary
Anxiety is a common and complex condition that often requires a multi-treatment approach. While acupuncture is beneficial for anxiety, the effects occur primarily on the energetic and physiological levels. Acupuncture may also cause an emotional release in people with anxiety, and it can be very helpful to add tapping and other approaches that address the psychological dimensions of the person.
In addition to using standard TCM acupuncture points like LI 4, LV 3, SP 6, and PC 6, it is also useful to apply Master Tung's points and methods, along with ear acupuncture, breathing techniques, exercise, and proper diet. Many cases of anxiety also have social and/or environmental factors that contribute to the condition, and these should be assessed as well.
Sources
Maher, James; Master Ching Chong Tung: Advanced Tung Style Acupuncture Vol 1: The Dao Ma Needling Technique of Master Tung Ching Chang, 2005, RBC.
Medical Acupuncture, A Western Scientific Approach; Filshie, White, Cummings, Public Domain Longhurst, 2016, Elsevier Publishings
Current Directions in the Auricular Vagus Nerve Stimulation I – A Physiological Perspective; https://www.frontiersin.org/articles/10.3389/fnins.2019.00854/full#F1
Ear Acupuncture, 2nd Edition; Beate Strittmatter M.D., 2011, Thieme