My heart keeps racing, and I feel a tightening in my throat | Incheon Anxiety Disorder

Hello, this is Baekrokdam Korean Medicine Clinic.

“I don't feel stressed, but my body feels strange.”

Some people say this as soon as they enter the consultation room: “I don't feel particularly stressed, but my heart keeps pounding, I feel a tightening in my throat, and sometimes I suddenly feel dizzy. I even went to the hospital, wondering if something was wrong with my heart, but the tests showed no abnormalities.”

Patients who describe these symptoms generally don't perceive any distinct psychological anxiety, but in reality, they are experiencing an imbalance in their autonomic nervous system. While they may not consciously recognize their emotions, their body is already reacting.

Emotions are suppressed, but the body reacts.

This state is often related to emotional suppression. Individuals who grew up in environments where expressing emotions was considered dangerous or unnecessary from childhood, or those who have always had to play a strong role, are trained to 'not feel' their emotions. They won't express anger when they're angry, nor will they feel anxious when they are.

However, emotions don't disappear; they remain within the body, unexpressed. When these suppressed emotions exceed a certain level, they begin to manifest through physical pathways. Symptoms like heart palpitations, throat constriction, cold sweats, dizziness, and sleep disorders are examples of this.

In Traditional Korean Medicine, this is referred to as 'Ul (鬱)'.

The character '鬱' itself encompasses meanings of feeling wronged and being condensed or pent-up. It refers to a state where emotions are unable to flow freely and become blocked, thus preventing the circulation of 'Qi' (vital energy).

Traditional Korean Medicine Interpretation: Qi Stagnation, Upward Qi Counterflow, Liver Depression

• Qi Stagnation (氣滯): The flow of Qi becomes stagnant, causing symptoms such as a feeling of stuffiness or oppression, belching, and sighing.
• Upward Qi Counterflow (氣上逆): Qi fails to descend and instead surges upwards, leading to symptoms like heart palpitations and a feeling of throat obstruction.
• Liver Depression (肝鬱): Stress and repressed emotions obstruct the Liver's functions, creating a state prone to transforming into 'Fire' (火).

These mechanisms interact, leading to an imbalance in the autonomic nervous system, and a state where emotions and the body seem disconnected. Particularly, symptoms concentrated in the chest and throat can be seen as a type of Upward Counterflow Syndrome (上逆證), where Qi surges upwards from the diaphragm.

Treatment Strategy: Address the Body Before Emotions

In such a state, simple psychological counseling or pharmacological treatment alone is not sufficient. This is because psychiatric intervention is limited when one is unable to recognize their emotions. First, it is necessary to stabilize the body's condition and create space for emotions to emerge.

In Traditional Korean Medicine, we approach such conditions in the following ways:

• Opening the Diaphragm and Relieving Thoracoabdominal Tension: Through acupuncture (침치료) or pharmacoacupuncture (약침), we relieve Qi stagnation around the diaphragm, creating space for deeper inhalation.
• Stabilizing Upward Qi Counterflow: Prescriptions that calm the surging upward Qi are utilized—for example, Ondam-tang (溫膽湯), GamiOndam-tang (加味溫膽湯), and Bupleurum-based formulations.
• Activating Qi Circulation: To circulate the suppressed Qi, we combine acupuncture (침치료) or Chuna manual therapy (추나치료) to open circulation pathways between the abdomen and chest.

Concurrently, we guide patients in 'training to express their symptoms verbally.' For example, they are encouraged to observe "what thoughts cross their mind when their heart pounds" or "what situation preceded the onset of these symptoms." This is not about forcibly extracting emotions, but rather a training to observe and connect with the body's signals.

It's not that you have no emotions; you've suppressed them for too long.

If you say you're not anxious, but your body keeps sending unusual signals—it's not that there's no anxiety. Rather, emotions that have been suppressed and trained not to be recognized for too long are manifesting through the body. In such cases, simply comforting the mind is not enough. The body must first release, allowing emotions to follow. When there is no language for emotions, starting treatment with the language of the body—this is the first step of care we can offer to these patients.