What is a healing crisis?  Do healing crises happen in the context of Chinese medicine?  How can we differentiate a healing crisis from a simple exacerbation or a new illness?

A healing crisis occurs when a person becomes ill in the service of becoming more healthy.

We could think of a deep seated abscess finally coming to a head as a kind of healing crisis.  It is a term that is often associated with homeopathy.  A homeopath sometimes expects a healing crisis as a sign of the remedy working.  However, the term “healing crisis” is not often used in the context of Chinese medicine.  Do our patients experience healing crises while in the process of getting better with Chinese herbs or acupuncture?

In the world of alternative medicine we have all perhaps seen the concept of a “healing crisis” used to explain away a patient’s lack of response to treatment and worse, to explain away a negative reaction to a treatment.  “My naturopath told me that this rash is the toxins coming out”  or “my chiropractor told me that these headaches are part of the process of getting better”.  And yet, the rash just gets worse or the headaches don’t go away…..Perhaps we’ve all had the experience of a patient reporting a new symptom such as a rash, headache, nausea, aching etc. and we have wondered if this is perhaps a healing crisis.  I’ve seen many hopeful patients wanting to believe that a new symptom is arising in the service of getting well, so much so that it would be very easy to encourage them to believe that the new symptom or exacerbation of a symptom is part of the healing process.

In my own practice, it is not uncommon for me to see patients going through healing crises.

Yet, when a patient comes in with an exacerbation of a symptom, or a new symptom, my first task is to make absolutely sure that the symptom is not arising due to mistreatment on my part.

How do we tell?  I’ve developed guidelines for myself.  These are helpful not only for me but for patients themselves.  When they use these guidelines, they can pay attention to what is happening and evaluate for themselves if it is indeed a healing crisis or simply a worsening of their health.  Here are the guidelines I use:

  1. The new symptom or symptoms comes on AFTER the patient has been feeling noticeably better or their main complaint is noticeably better.
  2. The new symptom or symptoms are less severe than the main complaint (i.e. a common cold is less severe than hypertension)
  3. The patient has a distinct intuitive sense of strength or well-being while the symptoms are happening or the symptoms actually feel really good.
  4. The new symptom or symptoms change rapidly and go away quickly
  5. After the new symptom or symptoms are gone, the patient feels better than they did before the symptoms arrived.

If the crisis meets  these guidelines, I will define it as a healing crisis.  If not, it is just my patient getting sick in a new way…back to the drawing board for me!

The main reason we need to recognize a healing crisis for what it is is because we need to recognize when our patient’s exacerbation or new symptoms is NOT a healing crisis and they are just getting worse!  Above all do no harm.

The common healing crises I have seen are:

  • Common colds (especially in people with chronic illness who have not gotten a good old-fashioned common cold for a long long time)
  • Rashes
  • Fever
  • Emotional discharges
    • Crying(I’ve seen people cry and cry for a week after acupuncture.  One woman had not cried for 20 years, even through the death of her beloved husband)
    • Anger (I had a patient finally start speaking up for herself and get out of a very unhappy marriage – but for a week she just could not believe how angry she was!)
  • Short lived insomnia
  • Short lived extreme fatigue (usually people who have been hyperactive or hyper-alert for a long time)
  • Diarrhea or Constipation

One colleague of mine thinks that inducing a healing crisis is a sign of poor pacing in our clinical approach. He thinks that proper use of methods would avoid healing crisis altogether.  I’ve pondered this thought.  What I have come to is that, for me, the healing crisis always comes as a surprise that is after the fact.  In other words, I can’t go back and try treating differently.  In each case, I think back to the methods I used and, without exception, they seem right-on to me and the healing crisis seems like a welcome relief – like this hypothetical boil coming to a head.  My sense is that the concept of “healing crisis” needs to be carefully integrated into our repertoire.  I believe that these guidelines must be diligently used.  We must be very willing to recognize and admit a real exacerbation.