Acupuncture, Ecology, Spirituality

A Dialogue on the Nature of Health and Humanity

Introduction

I first met Paul in Portland. It was 2021, and we were both studying Worsley Five-Element Acupuncture at the Worsley Institute. In the last year or so, Paul and I started getting together for friendly chats on acupuncture, astrology, and related topics. Our conversations were mutually thought-provoking and created space for an ongoing dialogue. A few weeks ago, we finally decided to record one of our free-ranging conversations. The edited transcript of this talk became “Acupuncture, Ecology, Spirituality” (text and audio below).

In “Acupuncture, Ecology, Spirituality”, Paul and I share perspectives on the nature of health and disease through an exploratory dialogue that spans five-element acupuncture, astrology, alchemy, and psychedelics. The central thread of our conversation reflects an ecological orientation toward health and voices a concern for our relationship to the natural world.

In conversing with Paul, I was reminded of the value of dialogue amongst colleagues. In traditional contexts, practitioners engaged in lively debates and scholarly explorations that brought forth tremendous innovation over the centuries. Medical tradition thrives in dialogue, where conversation invokes an oral episteme and a collective ethic of practice.

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About Paul Arellano

Paul Arellano is an acupuncturist and herbalist working in Portland, OR. He studies the interplay of climate and human health through the Wuyun Liuqi system of ecological health science. In addition to studying and writing about seasonal dynamics in nature and health, Paul offers BaZi natal chart readings, which uses the 5-Element system to create a "landscape map" of personal constitution and character. In these readings, Paul explores how each individual can harmonize with their own inner nature and enter into resonant, healthy relationship with the living forces of our world.

Read Paul's writings on seasonal resonance here
Wuyun Liuqi Climate + Health Map for 2025 can be found here

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Acupuncture, Ecology, Spirituality

Paul: Good morning, Neeshee.

Neeshee: Good morning, Paul.

Paul: We are here today to talk about the nature of healing from our perspectives, and I would love to hear what your perception of health is. What is health to you, and what is healing?

Neeshee: That is a big question. If I were to approach that question universally, I would say that health is a very individual matter. “What is health” is something that you can consider in the context of a unique individual. What is health for me may not be what is health for you. I may be able to engage in activities in my life that might be imbalancing to you and other people. So I think health is all about discovering who you are, and then realizing what it means for you to be healthy, what it means for you to be a vital human being. Health is very relative. The traditional medical systems point out that health is very much determined by our environmental relationships.

For example, I am here in Colorado—it is relatively dry compared to Portland. I have to take into account different things because of that fact—the climate that I live in, the environment and the elevation are very different. There is also my own constitution in relationship to the environment. So I think of health as being relative, environmental, and personal in the sense of the uniqueness of the individual. You can think about that astrologically and with systems like human design. Who are you? What is your nature? What is your design? That is what health is relative to.

Paul: What I'm hearing you say is that healing is discovering who you are. There’s also the aspect you mentioned of change. I was just seeing the release of a new commentary on the Yijing and reflecting on how the Yijing is a foundational text for an entire culture. Also, the medical lens of Chinese medicine is based on how things are constantly changing and transforming.

I'm hearing that there's both an essential nature that we all have to discover in ourselves, and then how we relate in that essential nature to the changing world around us and the changing environment we find ourselves in.

Everything is in flux, including who we are.

Neeshee: Yes, exactly. I think of the relationship between ourselves and the environment as a bidirectional reality. On the one hand, there is this blueprint of who we are. For example, I look the way that I do, for the most part, but I've also changed. In this sense, my structure and personality will develop and emerge, but it has a foundation-pattern, you could say.

The Book of Changes is pointing out that everything is constantly in flux, including who we are. We just need to discover the resonance between our flux and the so-called outer flux, right? We need to come into relationship with the reality of nature, the reality of the cosmos and the cycles of things. And there are many levels of the cycle. We have our own life-cycles that we go through, as astrology points out with the Saturn returns and the midlife period being a nodal decade. There are all these periods that we go through that are developmental. And there is also everything that is cycling outside—the season and everything that is happening in nature. Depending on where you live, that cycle is different. So there is a lot of strata to it, I would say, in us and in reality.

Disease is when things are changing around us and we are not changing with them.

Paul: You know, working with Bazi,¹ a big part of what I'm looking at is also the changes and the nested cycles of yin-yang—how we have day and night, a yin-yang cycle. We have full moon, new moon, we have summer and winter—we have all of these cycles that are playing out with different aspects that become very, very complex as you see them all nested together and moving at different rates. In that sense, to move to “what is disease”: what I'm feeling (and I think we probably share this) is that we are constantly changing and the world is constantly changing around us in so many different layers. Disease is when we are either changing in a way that is not resonant with the world around us or when things are changing around us and we are not changing with them.

So either we are changing in a direction that isn't coherent with our environment or our environment is changing and we are not moving with it, which I think is two ways to say the same thing. Even in the early chapters of the Su wen,² when it discusses how early on the cures for diseases were just instructions or shamanic incantations to realign that resonance.

We live in a world where more and more is managed—we have air conditioning, we have all of these conveniences that allow us to change, to make changes to our micro-environment, which means that our body is less in contact with the environment. Our consciousness is less in contact with the global, the cosmic consciousness of the changes happening on Earth. And that means we need more and more. And it says so in the Nan Jing that more and more invasive healing processes or procedures are needed because people's connection is becoming further and further estranged from that core resonance.

Disease is a superimposition on what is otherwise already the case.

Neeshee: I agree with that. Building on the resonance idea: health is resonance and disease is disharmony. I think that brings us into the paradigm of circulation. When you are in resonance with reality––with the cycles of things in yourself and in nature—then the vital force circulates. (You can call this vital force, qi, or whatever you like. I like the phrase “vital force”—it is a European phrase that I think is accurate.)

There is a vital force, a vital impetus, an intelligence that circulates as a connecting factor between our bodies and what is happening in the natural world. These are not separate realities. We realize that they are not separate through the circulation of the vital force.

If the vital force is circulating, that is itself the harmony of life. Something would have to interrupt that in order for disease to arise. Disease is very much a superimposition on what is otherwise already the case—which is the circulating motion of the life force. This raises the issue of adaptability—our ability to adapt and meet the changes of life. For example, to consult the Yijing, because we are feeling like we don't know, that we need to inquire relative to what is happening. What should I do? There is this inquiry in the Book of Changes around divining health and what the correct course of action would be, so you can maintain your correctness with everything.

As you said, industrialization and modernity have created this kind of capsulization of our life. Our sense of the body is not related anymore. We are living in controlled environments and even increasingly virtual contexts of communication. Communication, in its essence, is the vital force itself. As soon as you establish a virtualization of communication, you lose the spirit of life.

Paul: Very, very literally too—it disrupts the bio-rhythms that sync us to the environment.

Neeshee: Yes, the blue light and whatnot. We have abstracted the human experience. I think it's interesting what J.R. Worsley said, that when he was growing up, there was less provision for protection from climatic factors. In Chinese medicine, Ayurveda, and Tibetan Medicine, there is so much focus on climatic factors. If it’s damp outside, you don't want to get rained on and cover your necks in the wind so you don't get wind invasions. There is this whole idea that disease is primarily an invasion by climatic factors. I think that is partly an old idea. It is still true, but at least where we live today, we are rather protected from those realities—and we even have the option of insulating ourselves from it in a useful way.

But, at the same time, Worsley points out that even though we have all these modern provisions and protections from climatic factors, we are more ill than we ever have been. And that illness is a spiritual illness. Spiritual illness is precisely this virtualization, this disconnection, this non-communication, and the fact that our bodies are not vital anymore.

Paul: Yes, and when you say spiritual illness, I think of “spiritual” as the vertical access of something above us looking down. It is like the metaphysic we bring to the world, how we perceive the world. I think a lot of our attitude towards that is the same attitude that Western colonialism has had for hundreds of years, which is that nature is inherently dangerous and bad and evil. Now, I don't think that is what is being said in the medical classics, that wind is bad or damp is bad. They have consequences, but they also have a beautiful balancing effect where the wind comes in the Spring and moves things that are stuck.

The alternating dry and wet of the Shaoyang season of Spring helps to break open the soil and aerate things. The wind dries damp, it comes along and it can impart health to us as well. But again, when these things are out of balance—as climate change and other phenomena that create extreme weather that we are seeing so often—those extreme weather patterns really accentuate whatever that dynamic is.

So there is that lack of communication. There is a lack of even communication between the weather patterns. We see that health is not just a personal process of humans being sick—the environment becomes sick, and the weather becomes disrupted and abnormal and unhealthy.

To bring it back to the Book of Changes, the advice it gives is a lot about behavior, as you were saying. So much of health is not necessarily taking a drug or a medicine, but it's the question of how we comport ourselves. How do we relate and behave in response to what's going on around us? I think that is a real challenge of our times, for all the reasons we've said. We have a lot of insulation when there is something we don't want to engage with—we have a lot of ways to disconnect, to remove ourselves. The muscle becomes a little weaker regarding how we face something challenging and discover how to relate and have the flexibility to respond to it.

Neeshee: Exactly. One of the things you're pointing at is this age-old axiom that the causative factors of disease are also the causative factors of health. They are the same thing. They are the exact same process or entity or force—whether that is a climatic factor or a dosha or qi or blood or body fluids, or however you want to think about it. These things maintain the body. They maintain the mind and the spirit. They maintain our vitality. They are expressions of the vital force. They are not problematic.

In past conversations, we have talked about the five elements and the emotions that correspond to the five elements. These are not necessarily pathological. They are just showing you the natural cycle of change and growth—the ripeness and the decomposition. It all creates this beautiful cycle of health and healing and therapy.

But the factors of health can also become the factors of disease. So there are two ideas in there. One is the idea of disease as an excess pathology, meaning something accumulates that naturally exists and that imbalances you, such as damp accumulation or wind invasion. Second is five-element thinking (which is homeopathic thinking), where health isn't an excess of a substantial process of any kind but a deficiency in the natural cycle of things. The idea of pathology as excess is more humoral—it has more to do with the idea of a physiological substance or an environmental substance accumulating in you.

Ayurveda, for example, has a significant emphasis on this notion. Its primary modality is to advise patients on diet and lifestyle—behave in this way and eat in this way during this time of year. And that is largely the medicine, I would say. As you said earlier, given the times we've developed the need for more invasive procedures, and I think acupuncture is significantly more invasive, because now we are not just advising the patient, we are intervening in their physiology. And that is a different kind of event. It is a different kind of therapy. I think it is a lot closer to shamanism, which is the origin of medicine to begin with. That makes acupuncture a really interesting phenomenon that is resurrecting the past while bringing us into the present reality and the kind of therapies we need today.

I faced this frustration myself in the clinic, originally being an Ayurvedic practitioner, and realizing that just advising patients wasn't quite enough. Even more, their ability to make use of advice was also limited in many ways by the nature of their imbalance, which was a very real thing. I always thought that if I could just effect a change for them, a shift in their physiology, in a more immediate sense, they would have a greater capability. And not even a capability. I wouldn't even have to advise them. Their own bodily intelligence would emerge of its own accord. They would know what to do.

In the process of engaging with disease,
there is an important lesson to be learned.

Paul: Absolutely. For me, that connects to what you were mentioning: the link between a process of disease and a process of health often being the same. So much of what interests me in the lens of Bazi and the Wuyun Liuqi is how we see our own body’s processes of health reflected in the environment. They are not actually separate, as you were saying. They are happening in tandem. The more we communicate between those two, the greater the impact on health for both ourselves and our community, our environment. For example, there is a big patch of Ivy outside of my house, and I’ve been cutting down the Ivy. I was talking to someone recently, and they were mentioning the health benefits of Ivy. We think of it as an invasive plant, but it binds soil to prevent erosion.

And how beautiful that is, that it can in some ways be seen as a disease process, as an invasive plant coming into an environment where it doesn't belong and creating an imbalance. But that process is trying to return to a homeodynamic state of health, where it is balancing out what is imbalanced. What I find, personally, and through applying acupuncture to patients, is that people come in to seek relief from a symptom, but in the process of engaging with their disease or their disharmony or imbalance, there is an important lesson to be learned, an important healing that is going on through the arising of disease. I don't know if that is true in every single case, but I think in many cases, that is a part of the healing—the person's engagement and learning, rather than just removing a symptom where the person does not get the opportunity to understand what is being taught or what is being presented as an opportunity to grow.

You can think of symptoms as signifiers,
a sign you can decipher in order to deliver a treatment.

Neeshee: That reminds me of a quote by the famous Parisian psychoanalyst, Jacques Lacan, who said, “Love your symptom as yourself”.³ That also reminds me of one of the earliest Eastern medical definitions of health, which is in the Caraka Samhita, an Ayurvedic classic. It says, “Health is not the absence of disease”.⁴ The idea being that, when we're talking about health and healing, we're not necessarily saying that there are no symptoms.

This is a critical point: sickness is part of health, too. The experience of symptoms is, in many regards, positive and part of a process of transformation and healing. If you do not ever have symptoms, then you are very repressed. We can think of that psychologically. The homeopaths say that it's good to have symptoms, it means that the disease is being expressed, and that is better than having disease moving into the central areas of the body where it no longer has a capability to express itself, where it no longer gives you a distress signal, it no longer has a sign or any kind of significance associated with it. Thus, you can think of symptoms as signifiers, as a sign you can read and decipher and uncover in order to deliver a treatment. The symptom is a communication, and there is so much wisdom in it.

I think we're way too quick to just eradicate the symptom, to attack the symptom as problem. It is the idea that delivering a therapy that is opposed to the symptom is going to engender a cure. Whereas I think cure is the exact opposite of that phenomenon.

Paul: I really like the idea of listening—that there is a communication going on, and to respect that communication, to not shut it down. It is the same as if a child is expressing themselves and being open to what that is—maybe it's not clear at first, maybe it's a little chaotic, but encouraging that expression allows the child to grow. It allows the body to be able to communicate more clearly when there are issues going on or something to present—the body will have that pathway for clear communication.

Neeshee: Exactly. It also means that a patient's own relationship to their symptoms and their body and their process and their content and their psychology and their dreams and their overall experience of who they are can shift from becoming a problematic. As a practitioner, I do not want to enforce the sense of problem for someone. I want them to experience a shift in their relationship to that. For me, that is healing.

Paul: Yes, coming into right relationship. This segues into something that I'm interested in from the five-element perspective as well, that we touched on a little bit before—which is the nature of the five emotions and how the five emotions relate in a lot of ways to behavior, to affect, to how we relate to the world. These behaviors can bring us out of balance and they can also bring us into health—not just as a pathological expression of something we need to eliminate but as a process of relationship, of behavior, of expression that can connect us to health that can also become imbalanced from an overuse or an underuse, an over-communication or an under-communication of that particular emotion. Is that how you see the five emotions as well?

Neeshee: You can have a deficiency or an excess. But given the nature of the five elements as an interdependent cycle, the root-etiology is always going to be a deficiency that leads to excess somehow or another. Everything needs to maintain its natural order. As long as it's maintaining its natural order, there is an appropriateness to things.

I think Worsley's emphasis on appropriateness here is crucial because he says that the way you diagnose the issue in somebody is by sensing what is inappropriate in the sense of incongruent. This is not the root-diagnosis is color, sound, odor, and emotion. But as a practitioner, you are sensing where something is inappropriate.

Why is this person expressing this emotion? It doesn't quite match with the reality of what's happening for them, the reality of their experience. It is something that is out of place, or conversely, they are not expressing the emotion that would otherwise be indicated. Such as grief when discussing the passing of a family member. That is a very cliché example, but it works. There is a disharmony in their affect. This emotion either isn't showing up—there is a lack—or an emotion is manifesting that doesn't seem to have a relationship to reality, so to speak. Again, I think that just points out that there is a disharmony, or a failure of transformation in the five-element cycle, that is leading to the person being stuck in a certain emotional mode. Trauma or shock can leave us in a fight-or-flight mechanism where we are effectively experiencing an event constantly. We don't move on to the next element, to the next emotion, in the cycle of things. If we did, then everything keeps transforming itself endlessly.

Health is about how we are resonating with the world around us.

Paul: The curiosity for me with everything you're saying is how these two processes come from, to use Leon Hammer's phrase, “like contact to stay intact”—ways to try and remain in contact or avoid some kind of negative experience they've had in the past keep their living process going, keep their vital force flowing. It can be an attempt to reach for something that they can't access.

There is the overreaching and then the avoidance of things. All of that is colored by the idea that (going back to what you were saying earlier) that health is so much about our behaviors being in contact with what we're feeling and what's really going on for us. How we are resonating with the world around us—whether we don't want to resonate and there's some process that's going on around us we don't really want to feel—but that inevitably we are, and to be able to sync up with that, or if there is some experience we really want to be having, some connection we really want to be making that's not as accessible in the world around us.

Coming into resonance with that, bringing it all back to how we can behave more appropriately. Not to say that we need to be censoring or chastising ourselves about inappropriate behavior, but just recognizing how that itself is a vector of health, as much as any intervention. As you were saying, a lot of the interventions we're using as holistic health practitioners are to help people achieve that state internally of this ongoing resonance where their body is maintaining a state of health, even when disease arises, even as processes of death are happening. To be in relationship to that, to be in rapport and dynamic connection.

That is something that I also think about a lot with my patients: how to not create that for them but how to see what's going on and try to witness a process going on for a patient from a lens of compassion and understanding that there is some learning going on here. The patient is seeking some kind of fulfillment, and it can't be pushed aside. We have to find a way to relate to it and find the fulfillment that is being sought after.

Neeshee: I would say an essential statement here: health is relationship. That relationship is also evidenced in the patient-practitioner relationship, which is a therapeutic relationship. Symptoms arise as indications of where relationship is being inquired of, where it might be avoided, where it may need to be reasserted or reestablished. Where it has been repressed. Therefore, when you have the event of healing (or the law of cure is initiated in that process), you will have symptoms. You will experience sickness as part of the process of healing because there is something within us that is not transformed, that is stagnant. You could think about disease in a very simple way as just a form of qi stagnation, which means that once it gets moving again, there will be purification, there will be a rebalancing process.

And that is such an exciting sign to see in the clinic because you know that the patient is healing, you know that they are being cured, so to speak. Here, cure is not a final event. It is an ongoing process. That is why when we talk about appropriateness, we have no sense of a Judeo-Christian value judgment. We have a Daoist sense of the harmony between things. The appropriate form of action. The Book of Changes says the superior man does this or the superior man does that, and it's another way of saying that when you're in harmony with yourself, you behave appropriately in respect to what is happening. You are in relationship—you are related fundamentally to your own body, and your body is existing in the relationship that it exists in to the world, to society. As you've also been hinting, there is a cultural and collective component of health and healing and, therefore, an environmental one.

Paul: Yes, and bringing it back to astrology, the cosmic: if you think of the universe as being a perfect encapsulation of dynamic health, it is always changing. There is no cure-state because new things are always happening, shifts are taking place. It is that process that allows health to move and balance. It is not always so smooth, but I think there is also the ability to see in the five-element model through these healing events or these symptoms or these emotions, exactly how they are relating. If somebody, for example, in the instance of somebody not grieving or not displaying grief for a family member, having the appropriate grief might be absolutely heartbreaking and a terribly intense emotion to feel. But we can understand that that is an appropriate response to help the person come into relationship with a process that is true. Whatever other supports might need to take place in that person's life, just support that.

The other instance I can think of is when we think of excess Earth element or the seeking of sympathy and care, and the excess seeking of support and affirmation. In the five-element cycle, Earth controls Water. When we take away that excess, we have the Earth trying to hold onto the Water, which is fear. In the absence of a kind of affirmation and sympathy, there could be a great deal of fear and loneliness that I'm not connected as I want to be. I don't have this big holding loving community in the same way that I'm really looking for. That could engender a lot of fear. But, at the same time, we can even see how somebody coming in, experiencing a great deal of fear after the previous session, maybe being lovey.

It isn’t always a bad thing, and it's not our place to ascribe who should be feeling what emotion—but we can understand, as they present themselves, where they might be coming from. I think that is a beautiful way of relating to emotions.

The symptom is the key, but not the object of treatment.

Neeshee: What you said is that the symptom is like a homeostatic process. The symptom is not a deviation, it is an attempt of the body to reassert a natural order. What we can do is look at that and say, Oh, this is what is trying to happen. There is a reason for it. It is very rational. We can assist that motive to complete itself, to fulfill itself. Therefore, the symptom is the key, but it is not the object of the treatment. The symptom is the message—so you can really listen to your patients and learn so much. Applying this more clinically, I will share some of my recent thinking on five-element practice and Worsley’s concept of the Causative Factor (C.F.), which is the one element that is constitutionally out of balance in someone.

I think about the C.F. as a relational imbalance, and the whole five-element cycle showing us the relational nature of health. You were just giving the example of Earth and Water, the control relationship. There are so many relationships in the elements. We have the generative relationships, the Mother-Child relationship, which is the most basic relationship in reality. We come from mothers. There is no other way that life exists. There is so much to be said about birth trauma and the early stages of infant care in setting up the psychological foundation of a child to be an adult. I think of the Mother-Child relationship between the elements in a metaphorical and alchemical sense, but also in a very literal sense.

I would propose augmenting Worsley’s idea, or sort of creatively playing with his idea of the C.F., by saying that you can offer five-element treatment that is not solely focused on the C.F. element (which would be his method), but that you can treat the C.F. in the context of its relational reality. You can treat the C.F. as a relational imbalance, not as an individual imbalance. Because there is no individual, really. It is all relationship. For example, say you diagnose a Wood C.F., you can do a Water-Wood treatment. This is very much like Japanese Meridian Therapy, although they arrive at their diagnosis through pulse and not through the color, sound, odor, and emotion. And they have a very specific way of doing the treatment.

I'm saying you can use any points on Water and Wood to transfer the relationship, to reinitiate the Mother-Child relationship, to bring in the context of the Wood element again, and give it an opportunity to rebirth itself, so to speak. You can also take this idea and look at the control cycle and be attentive to when that is needed, when that relationship needs emphasis. Because if everything is being controlled properly, it is being maintained in check. When would you need to assert control? When something is excessive or when it is being over-controlling, then you need to relax.

If we think about the C.F. as an element, then we're necessarily thinking about a dynamic of relationships. Korean Four-Needle Technique operates on this idea too. It is bringing in these relationships between the elements, again, in a very specific way. You use certain element points, the horary point, etc. I’m broadening that whole idea and saying we can use any points on any of these meridians to re-enact the relationship. So that is an idea I am playing around with.

Paul: The work that I do with Bazi is based in the same five elements, and a lot of it is diagnosing from a different perspective, a similar idea of the Causative Factor where we're looking at somebody's chart. And the way I perceive the chart, it creates a natural landscape. There are all the natural elements of Fire, Wood, Water, Earth Metal in different combinations in different organizations and structures. Thus, it elicits the image of a landscape. In that landscape, there might be something really excess, there might be something really deficient. It’s thinking about what elements we need to bring into that landscape to balance the system. It might be more than one, it might be a little bit of one, a lot of another. There are certain Bazi charts we look at where if somebody's born on the right day of the right month, they're born in the summertime, let's say, and their heart's full of fire—that is not necessarily a problem because the summer is the time of fire.

We have to understand what is appropriate for one person. Partial people might have a strong partiality to a certain emotion, a certain kind of display. That is also part of the human experience. Some people who are just more gregarious, more intense, more compassionate. And that can also be part of the human experience. There is a beauty to that. Even recognizing within each individual that there are still things we need, but at the same time, there are things we offer. We have gifts to return to the world.

That is such an important part of healing, and why relationality is part of healing. Because we do need the assistance of the world for our causative factor or for our deficient elements, something that we need to bring in to help support us. At the same time, we have something to offer back to those who seek it, who need it in the world around us. And the stronger that web of relationship is, the greater the exchange of health across the entire network.

Neeshee: Exactly. And I think that's why methods like Bazi and astrology are great—they show you where you are eccentric. We all need to discover our eccentricity because, when we do that, we also discover our genius. That means we are not only discovering our character, but we are realizing the calling that exists in us. That is what individuation is about, in the Jungian sense.

My colleague, Howard Chen, has thoroughly applied the Bazi methodology to five-element acupuncture. In his system, the Day Master is the C.F. So you center treatment around the Day Master element, and you look at the four pillars as a whole, and all the elemental relationships.

On that basis, you can derive the elements that are most indicated in treatment, to support the CF, so to speak. Now, my revision of that is to say that the Day Master is not the Causative Factor; it is the Constitutional Factor. The CF is an imbalance. In some cases, they are the same. In other cases, they are not the same. This is a very Ayurvedic idea, that there is a constitution and then there is an imbalance. I think the Day Master is a constitutional factor in the true sense of that phrase. Does it need treatment? That is a question. You can support it, for sure. But I also think the CF that Worsley is getting at is slightly different from that. It is arrived at through different means, and it has a dynamic relationship to the constitutional factor. That is the whole prakriti-vikriti⁵ idea in Ayurveda, which I think is the original constitutional medicine. Ayurveda has a strong theoretical explanation of constitution and its relationship to imbalance.

The herbs we ingest are a mirror of their function in the environment.

Paul: I think that also, and I wonder if this is what you're saying as well, because it makes me think about plants again:

A big fascination of mine is how the herbs we ingest, whether Ayurvedic, Chinese, or Western, the way that they function in the body is a mirror of their function in the natural environment. There is a resonance between what we are ingesting the herb to do for us and what they do naturally in their community. We are ingesting that relationship to take that relationship in. Similarly, we have constitutions that are partially what we give. But those can't exist on their own. We need to have a healthy community where we are getting what we need. Again, that whole relationship dynamic where our constitution isn't necessarily what we need more of, there could be something different we need that supports our ability to express our constitution.

The emotion that has always made me most curious in the five-element system is the emotion of joy. Because I think that is such a sought-after emotion in Western culture—the experience of joy. So much of our consumer landscape is centered around what will impart joy, what will give you an experience of joy, of levity, of ecstasy. Maybe ecstasy is wrong because I think that it is not always a joyful experience. We mentioned this before as well, thinking about the idea of health being held in relationship and held in a whole network of community relationships. I've been fascinated lately by the idea that the root system of any ecology is like the brain of that ecology.

The behaviors of an ecology, how things grow and relate, are based on the interconnection between all the roots that are going on unseen, and mediated mostly by mycelium. So all the roots are down in the earth, and then filaments of mycelium, almost like a neural web, are connecting all these, and they're all sending chemical signals the same way our brains send chemical signals, and they're being passed to one another, communicating, sharing information, sharing resources. That is creating, on a macro-level, behaviors and responses. My interest in this is the fact that serotonin, before it was ever in an animal brain, was in the root systems of plants. Serotonin is being synthesized by plants and shared among them.

A lot of attention in our culture is paid to SSRIs, to depression being a function of a serotonin imbalance. These chemicals are also present in the environment. Therefore, we can think of the environment also having joy, having that same emotion. We can understand more about ourselves by looking at the natural environment. What we see is that a lot of psychedelic chemicals are derivatives of serotonin. So there is some kind of modulation of this experience of joy or openness. What these chemicals do is they encourage diversity of root growth—and, if we're imagining roots like the neural network, that is encouraging neuroplasticity, encouraging a new response to an existing situation.

When the stressor comes on to an ecology, there is an uptake, an increase in the production of these chemicals that allows the root system to grow in new ways, to synthesize new chemicals, to respond to a trauma or an unexpected event. I think that's a really interesting way of conceiving of joy as well. That joy isn't always a response to something happy or a joyous experience. Joy can be an opening to something that otherwise is very painful. That through grief, through fear, through anger, there can be an experience of joy, which literally in our brain allows a new relationship to an existing situation to open up to possibilities other than being stuck in this one loop, and that literally can create new connections, new structures in our brain. That is a beautiful part of the whole system, that we do have these more challenging emotions that we tend to think of as fear, anger, or grief. Joy is a much more pleasant one, but it's a really necessary part of our growth, our adaptation, and that relationship to what's going on, to take a new stance, develop a new way of relating, and the environment reflects that back to us.

Neeshee: It's another way of recognizing the mechanism through which psychedelics can help us grow. That is how I think about psychedelics: they offer tremendous growth potential for the right person in the right context (obviously set and setting, etc.). But I also think that you're pointing to the fact that health is an ecological phenomenon. And that takes us into the realm of possession.

When we lose relationship (or health as relationship), we become unrelated and dissociated. That is possession. Possession isn't some other entity coming into us. That is an old idea. It is a symbolic way of saying it. Most fundamentally, possession is the experience of the “I”. The experience of oneself as separate is possession because now you are possessed of yourself.⁶

You are not related. That is why the Tibetans talk about possession as an ecological issue. If you start cutting trees down, you disturb the spirits that live in the land, and they will possess you. You invoke the wrath of nature. The Tibetan medical texts say that epidemics arise from environmental destruction. By devastating the natural environment, we create epidemic diseases. We provoke the wrath of nature. We become possessed by viruses. Our whole gut-brain axis becomes a form of dysbiosis rather than an ecological intelligence. So this whole thing about healing as relationship is healing as ecology.

I'll give you an example. What you just said reminds me of something my spiritual teacher, Adi Da, talked about, which is that the tree is the most fundamental natural structure in existence, and that the human being is the mobile realization of the tree structure.⁷ This means our verticality, but also the relationship between Heaven and Earth. The tree is rooted in Earth, and it's open to receiving Heaven through the crown. Adi Da specifies the metaphor by saying that the brain is like a root ball, and that the body is underground. Spiritual awakening is growth above ground, overhead, into the domain of the sunlight, so to speak. I think that metaphor is also quite literal. He is pointing to the structure of the human being and saying that we haven't merely co-evolved with the plant world, we are an evolution of the plant world. We are plants in a mobile consciousness.

We are plants. So it makes sense that we would use them for healing. As you were saying, there are derivatives of serotonin, and I think these are all things science has discovered as a language for this relationship. But it is just the language of ecology and, really, the language of our medicine.

Paul: Yes, what I hear you saying is that cows are vegetables, so it's okay for vegetarians to eat a burger.

Neeshee: <Laughter>. That's right. You have gotten my point.

Paul: I love extending that a little bit, that we are plants, but we're also not just a tree getting up and walking around, but we bring our entire ecology with us. We are talking about the gut-brain connection. We have a whole flora, we call it the gut flora. We have a whole ecology within us. I love the idea that when we lose healthy relationship with the external environment, that reflects in dysbiosis, that reflects in psychosis, that reflects in a loss of healthy relationship on the internal level, which is also in ecology. We take for granted the idea of possession, that there's one “I”, but it is a collective of all sorts of beings that need to be kept in harmony and in relationship.

And if they're not, we see the immediate effects. The more we are in healthy relationships with the external world, that will reflect in our own internal state. For example, brain chemicals are released when we're in healthier relationships, such as oxytocin, serotonin, etc. When we are in a good relationship with the seasonality, the appropriate dynamics are immediately reflected in our internal world. Of course, there are always storms, there is always sickness. These things happen on the inside and out, but those aren't signs of illness. Those aren't signs of a lack of harmony. Those are events that we then need to respond to.

Neeshee: I think that this allows us to look at the phenomenon of neurosis. We can appreciate the neurological component of that. We can also appreciate the psychological component of it and the ecological component of it. Freud used the word “neurosis” to indicate a psychological imbalance. Jung’s definition of neurosis is “one-sidedness”, a partiality of consciousness. So I think neurosis is an interesting word because it targets the zone that you're talking about—the brain, the nervous system, and the way that is a reflection of the plant world—but also the psychological, ecological, and the reality of relationship. If we are one-sided in any way, we are missing the picture of our wholeness in relationship. We're capsulized again.

Paul: One-sidedness was always a curiosity for me as well. What does it mean when there is an excess of joy? We can see mania in the world, but joy seems like such a good thing. Why should we be worried about an excess of joy? It’s helpful to understand that through the lens of brain chemicals and psychedelics.

Psychedelics in the plant world help to promote a diversity of new neural connections through the root structure and the death of old structures that are no longer in service. So it helps to cleanse old patterns, it helps to promote new, healthy patterns of relationship.

However, to ingest psychedelics to continue to be in a state of constant joy would not support long-term harmony. That will become too partial. It will become too one-sided without the other side of really drawing those roots down. Whatever these new connections are, we have to establish them. If we discover some new insight, making sure we can bring that out into the world and bring that into relationships and enact that in a way that becomes more visible, more solid.

A lot of the fear I hear people talking about with psychedelics is psychosis, neurosis. The relationship between internal and external is a really important aspect of health. We need to be connected to our internal world, but we also need to be connected to our external world. When we favor only one, we create partiality that can lead to disharmony.

Psychedelics need a therapeutic context.

Neeshee: I think that this points to the age-old exploration of the relationship between schizophrenia and mystical states of consciousness. The original idea of schizophrenia is a loss of vital contact with reality. That is the original psychiatric definition. I think that is accurate, but at the same time, it has been observed that the schizophrenic experience shares features with religious experience, with mystical experience. Yet, the schizophrenic is not relating to those experiences in a way that could produce realization, but they're having transpersonal experiences, even though they're actually in a pre-personal condition. Psychosis shares features with mystical phenomena, such as Kundalini.⁸ You can exploit the nervous system in the higher centers of esoteric physiology and have these experiences.

That is the question of integration. Psychosis is the inability to integrate these experiences, to bring them back into the ego structure. Now I'm using ego in a psychological sense, not as the “I”, but as the medium of relational connectedness. You take psychedelics and you have this ego dissolution, but it's not from doing Spiritual practice. It has no context. You are given access to something real, but it's not necessarily usable.

That is why I think psychedelics need a context. Like anything, they need a therapeutic context. This is one reason I'm in favor of MDMA, because it doesn't dissolve the ego structure. It actually brings ego integrity in the sense of bringing you into a somatic relationship with yourself, and it has a strong relational element.

I think that is more the zone of healing than having strong visionary experiences or ascended experiences. Maybe we don't need to go to Heaven. We need to have an alchemical flow between Heaven and Earth. If we look at the illness of our day, we are really not in our bodies. How powerful would it be to really be able to feel like you're in your lower dantian,⁹ that it is the center of gravity, that the hara is the centrifugal area of the vital force, somatically? To be able to relate to the world and other people from that place of centeredness and embodiment. Not as a self, but as a functional unit.

MDMA, because of what it engenders, is anti-possession. It is pro-relationship and pro-ecological. LSD and psilocybin, obviously, they're useful, but they're also very unpredictable, and they are really taking you into the transpersonal. If we are going to go to the transpersonal, we need to make sure we've really established the interpersonal. You can't just blip into the transpersonal when you haven't even come into relationship to your body, to your environment.

Paul: That reminds me of what Carl Jung said in his introduction to The Secret of the Golden Flower¹⁰. He says that the greatest mistake that any Western practitioner can make is to forsake their own epistemological underpinnings to pursue some mystical other experience. And related to that, he says that the goal is not to have visions of light, but to enter into the darkness and illuminate it, which is what you're talking about—going into our body, this place that we don't have a relationship with, it seems dark and scary and unknown. If we can bring illumination to that, that is more valuable than its pre-personal envisioning of these beings of light and whatever else might be that can't do anything if we can't bring that then into our body. That is like reestablishing the connection with our true epistemological underpinning, so to speak. Where are we? Who are we really in the world? If we can illuminate and inhabit that, then I think that gives access to the ability to potentially access these higher states of visionary experience. But there's nothing to do with them if you can't bring them back down.

Neeshee: It's a search to escape the body. Spirituality has been built around that in certain traditions. For example, the Kundalini tradition is about that. That is the goal—to raise the life-force to the point that you merge into a higher realm of subtlety. It’s a visionary realm. It also has a formless component when you reach the highest of the high. The idea is very much to subordinate the body to that. My bias is more towards the Daoist sense of yoga, in which you appreciate that everything needs to come down first. If you're going to practice the microcosmic orbit, first, the vital force comes into the dantian. First, everything flows down into the body. You are anchored in the dantian.

Only when the dantian is full can you circulate up the spine. Even then, the idea isn't entirely to leave the body and to establish yourself in a higher consciousness. It is to circulate. That is the secret of the golden flower. It becomes a complete flow in the circuit of the body. Honestly, that is what I experience when I do Qigong. That is what I experience when I'm with patients. And that is what I try to be. That is what I mean by the vital force and the flow of it being health. I want to feel that I'm in the microcosmic orbit. That is what is keeping me alive. It’s also an alchemical and Spiritual process. For me, MDMA amplifies that very mechanism and process. It's a tonification of the microcosmic orbit, rather than a shooting up of the Kundalini. We need somatic therapies—acupuncture has an advantage here.

Paul: When you said the “ego structure”, I had misheard you as saying “eco structure”.

Neeshee: That's a good mishearing.

Paul: Either one works!

Thinking about this web of relationship and also bringing things back into the transpersonal and psychedelics: when there is an environmental stressor on grasslands, grasslands are mostly held together in part by psilocybin mycelium, and they release psilocybin into grasslands when there's an environmental stressor, which promotes diversity of root growth. It even promotes the synthesis of novel chemicals to respond to environmental stressors. So it promotes a whole new way of relating that some plants might experience while others don't. When that experience happens, that is like the individuation process. That is creating a new kind of being who is capable of new things. Whether psychedelics are involved or not, that is potentially how all diversity of life occurs, through different responses to environmental stressors, different creative solutions that all life (including plants, human beings, bugs, and minerals) brings new responses, new adaptations to the environment.

That creates this beautiful diversity. If we're keeping that to ourselves or are not able to share that, then it dies with us, it goes away. But if we're able to put that back into the environment, whatever experience, whatever adaptation we have synthesized, to send that back into the root structure, to send that back into our community, to share that promotes the diversification, which we know is health in so many ways. It also promotes the ability to heal others.

I think that's a really necessary component of finding our own calling—both what we have to offer, but also how what we offer to the world is so much determined by the illnesses, by the stresses, by the ways that we encounter the world. That is something that we can only impart if we're willing to have access to a community, to a place to share that back with one another. We're existing in a world where homogenization is becoming so much the norm, where things are dying off, everything's becoming you know—

Neeshee: Mono.

Paul: Sterile. Mono and sterile. This diversification that needs to happen again can even start on the individual level, recognizing the value in our own challenges and struggles and illnesses. What we've learned from that being something that is more than just a personal process. It's something that we can and should be sharing with each other.

Neeshee: What you're saying points to the fact that the human process is one in which we have a responsibility for everything that we're related to, especially the natural world, and that we should be stewards of the world. We have this alchemical ability within us, as you said, to synthesize something novel, to increase diversity, and in a certain way refine it in our own bodies and put it back out in a way that serves its generation.

I'm reminded of an exchange between Terence McKenna and Sasha Shulgin, where Terence was going on about how the plant psychedelics are where it's at because they're natural, and things that aren't natural don't have a history of intelligence. They don't exist in a morphogenetic field that these plants have accumulated through generations of use. He says these synthesized chemicals are soulless. Sasha Shulgin was in the audience when Terrence McKenna said that, and he responded, “Terrence, I'm as natural as they come”. Which I think is such a great remark for somebody who synthesized so many novel compounds that were, in many regards, plant derivatives. Just that idea that “I'm as natural as they come” is so true. The human being is as natural as it comes—what we can synthesize in our relationship to nature, is the most natural thing that there is.

Paul: The last thing to tag onto that is, in doing some research, I saw that there were studies where people would introduce to a mycelium colony a novel chemical that didn't exist anywhere in nature. And by introducing it, the mushroom would begin to synthesize a parallel chemical. So, again, as natural as it comes. Things come from everywhere, and the more diversity there is, the more that gives us the opportunity to have a natural response, to develop that ability to create our own natural reflection and resonance with that.

Neeshee: I think that's beautiful.

Paul: Well, this has been so much fun. I've learned a lot, and I just really appreciate talking to you. Thanks for taking the time, Neeshee, to share this conversation.

Neeshee: Likewise, Paul. I really enjoy our conversations and I always learn a lot. I think it's a good dialogue to be engaged in, as a kind of invocation of health and healing and of our purpose.

Paul: I feel really enlivened and called to my own purpose through these conversations, and I hope people who listen or read feel the same, that it resonates with their own purpose to go out and heal themselves in the world and to do so in a way that's full of joy and community.

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1. Bazi refers to the Chinese calendrical system of the Four Pillars.

2. The Su wen is the first book of the Huangdi Neijing, a Han-dynasty medical classic.

3. In an interview, Sergio Benvenuto, recalls Lacan’s remark:

Symptoms tell the truth about a subject, they are not just traces of an illness. This is because Lacan said, laughing, “love your symptom like yourself”. Of course, if a symptom creates inhibition and anxiety it has to be analysed in order to tune up a subject with his way of enjoying. Psychoanalysis is basically not anti-psychiatric, but non-psychiatric.

Fake Interviews on Lacan: With Sergio Benvenuto - European Journal of Psychoanalysis. (2022, July 15). European Journal of Psychoanalysis. https://www.journal-psychoanalysis.eu/articles/fake-interviews-on-lacan-with-sergio-benvenuto/

Health is not merely the absence of disease. One who is established in the Self—who has balanced doshas, balanced agni (digestive fire), properly formed dhātus (tissues), proper elimination of mālas (wastes), properly functioning kriyā (bodily processes), and whose senses, mind, and consciousness is full of clarity and bliss—is known as a healthy person.

4. Caraka Samhita, Sūtrasthāna, Ch. 15.

5. Prakriti means “original nature”; Vikriti means “modification”. These terms are used in Ayurvedic medicine to connote “constitution” and “imbalance”.

6. See Pandit, N. (2024). Spirits of the Unconscious: Possession and Resurrection in Acupuncture Therapeutics.

7. See Samraj, A.D. (2005). Hridaya Rosary: Four Thorns of Heart-Instruction (pp. 185-196). Dawn Horse Press.

8. See Sanella, L. (1987). The Kundalini Experience: Psychosis or Transcendence. Integral Publishing.

9. In Daoist alchemy, the lower dantian refers to the lower abdomen. In the Japanese tradition, the lower dantian is known as the “hara”.

10. See Jung, C.G. (1962). “Commentary”. In The Secret of the Golden Flower: A Chinese Book of Life (R. Wilhelm, Trans.; pp. 81-96). Harcourt Publishing.