The seven emotions in traditional Chinese medicine

Traditional Chinese medicine (TCM) sees a close relationship between the internal organs and emotions. There are considered to be seven emotions in TCM. These are joy, anger, worry (pensiveness), anxiety, sadness (grief), fear and fright. Emotional activity is the normal response to external or environmental stimuli. Within normal limits it is not seen as harmful, and can actually be beneficial for the body and mind. However, if emotions are too abrupt, too powerful and overwhelming, or remain unresolved for a long time they may become pathogenic factors causing disease. Excessive emotional activity may cause yinyang imbalances, abnormalities in the flow of qi and blood, blockages in the meridians and damage to internal organs. If physical damage has occurred then it is no longer enough to repair the psycho-emotional imbalance. Work needs to be done to repair the affected organ/s as well so as to prevent a recurrence of the complaint. TCM calls this “internal injury due to the seven emotions”.

The seven emotions in TCM are seen as the physiological responses of the internal organs’ qi, blood, yin and yang. Each organ moves qi, blood, yin and yang differently resulting in different emotional responses. The ancient Chinese medical text the “Huangdi neijing” attributes the seven emotions to the five viscera.

Zang organ Corresponding emotion
Heart Joy
Liver Anger
Spleen Worry (pensiveness)
Lung Sadness (grief)
Kidney Fear
Activity of the qi in the organs Anxiety and Fright


Chinese medicine sees the medical world in patterns. Disease is referred to as “patterns of disharmonies”. It rarely sees things in absolutes. As with so many things in Chines medicine, the attribution of the seven emotions to the five zang organs is not absolute. The activity of the qi in the organ and the pathophysiological state of the organ can dictate the emotional response. A good example is the liver, an excess of liver qi can result in anger but a deficiency of liver qi can result in fear. Following is a table showing the effects that emotions can have on qi.

joy relaxes qi
grief exhausts qi
anxiety stagnates qi
anger raises qi
fear sinks qi
worry depresses qi
fright disturbs qi

Joy relaxes qi
Sudden joy may impair the heart qi. If the joy is mild then palpitations, shallow breathing, weakness and distraction may occur. If it is a  serious case then agitation, insomnia, palpitations and mania may occur.

Anger raises qi
TCM describes anger as a wide range of associated emotions including resentment, irritability, and frustration. Anger affects the liver leading to stagnation of liver qi. Stagnant qi is hot and as we all understand, heat rises. This rising stagnant liver qi may rise to the head resulting in symptoms such as headaches (in particular the vertex), dizziness, hot itchy eyes, irritability and irrational anger outbursts. Long term it may lead to high blood pressure, and can cause problems with the stomach and the spleen which then leads to digestive conditions such as Irratable Bowel Syndrome (IBS).

Worry (pensiveness) depresses qi
TCM sees pensiveness as a result of over thinking or excessive intellectual stimulation. Any activity that requires a lot of sustained mental effort runs the risk of creating disharmony. The organ most directly at risk is the spleen. This can result in spleen qi deficiency with signs and symptoms such as fatigue, lethargy, inability to concentrate, poor muscle tone and digestive complaints.

Grief exhausts qi
Long term unresolved grief can create disharmony in the lungs. Normal and healthy expressions of grief can be seen as sobbing. This originates deep within the lungs expressing as deep breathes with the expulsion of air in a sob. However, if this grief remains unresolved and becomes chronic, it can create disharmony in the lungs. This weakens the lung qi and affects the lung’s function of circulating qi around the body. Clinical manifestations of weakened lung qi may include shortness of breath, a soft voice or reluctance to speak, chest oppression and dispiritedness.

Fear sinks qi
Fear is a normal and adaptive human emotion which is part of our fight or flight response. In cases of extreme and sudden fright, the kidney’s ability to hold qi may be interrupted leading to involuntary voiding of the bladder, fecal incontinence and spermatorrhoea. This is particularly seen with children.

Fright disturbs qi
Fright is an emotion that is not specifically related to any one organ. It is distinguished from fear by its sudden, unexpected nature. Fright primarily affects the heart, especially in the initial stages. Sudden fright causes turbulence of the heart qi and abnormality of the heart-mind. Clinical manifestations may include palpitations and restlessness, consternation, dumbness, insomnia and anxiety. If it persists for some time, it becomes a conscious fear and the disharmony moves to the kidneys.

Anxiety stagnates qi
Anxiety blocks qi and prevents it from moving freely. Anxiety may injure the lungs which control qi through breathing. Signs and symptoms of anxiety blocking the qi are retention of breath, shallow, and irregular breathing. Anxiety can also injures the lungs’ coupled organ, the large intestine resulting in things like ulcerative colitis.

Understanding emotions and their effects on the body and mind

Diseases that are caused by an excess of one or more of the seven emotions is seen as emotional diseases in Chinese medicine. Conditions such as depression, depressive psychosis, mania, chest discomfort or real heart pain may have been caused or precipitated by an abnormal emotional stimulus. This could then result in abnormal emotional manifestations with a pathological course that changes with the varying emotions.

A good understanding of the seven emotions and their positive and negative effects on diseases can help Chinese medical doctors adopt a thorough and correct treatment method. The doctor understands that changes in the seven emotions may affect onset, development, changes and sequelae of diseases. Good spirit and optimism for example may help the patient recover. Conversely bad spirit and negativity may hinder disease recovery.


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