Katakori | Tech-Neck

 Do you get neck pain when you get stressed?

Do you get neck pain when you get stressed?

KATAKORI

A direct translation of Katakori  leads you to the term stiff shoulders. However it is used colloquially in modern Japan to express some form of stress or emotional distress that is generating a deep seeded pain in the neck and the shoulders. In Kuriyama’s essay ‘The Historical Origins of Katakori’ he describes Katakori as “mental tension manifest as muscular tension.” This pain ranges from the occiput following the nape and to the mid thoracic spine. In essence it covers the entire trapezius muscle and all of its attachments.

Kuriyama explores that idea saying ‘tension is inexact. To appreciate the distinctive feel of kori it may be useful to reflect upon what happens, sometimes, when longtime friends fall out. Harsh words are exchanged; feelings are hurt; ties are severed. Later, the friends begin to speak to each other again, but their conversations are no longer the same. Though they pretend a return to their former casualness, both know that it is only a pretense. The intense antagonism and tension that both felt at the time of the argument have long faded; but the resentments of the time have hardened into shikori- a term closely cognate with kori, and often used interchangeably with it- blocking all easy exchange. There are awkward silences. Communication no longer flows. The pain of Katakori is not unlike this dull and heavy ache of suffocated words, of feelings congealed and unable to ‘get through’.”

Katakori can be caused by all forms of stress and overwork. Culturally the Japanese have valued this kind of overwork. Where people are encouraged to work long hours and work through their exhaustion. This leaves less time to take care of the human necessities of eating, sleeping, leisure, and exercise. With the advent of smart phones (including the postural habits associated with cell phone use) and the extended hours Americans are working it is no wonder that the ailments known to the Japanese for centuries is affecting the American populations. As of a survey taken in 2015 15.7% of the total U.S. population had experienced Neck pain in the prior 30 days. People who were economically below the poverty line also showed higher levels of of neck pain; 19.9% experienced neck pain in the prior 30 days. It seems plausible that the trend in neck pain and Katakori like symptoms will continue to rise as the population ages.

‘I HOLD MY STRESS HERE’

In the west you hear people say the equivalent of the phrase Katakori in a few phrases: ‘that is a pain in my neck’, ‘ to shoulder the burden’ , ‘chip on your shoulder’ , and ‘I hold my stress here’. However these phrases do not explicitly or rather acceptably describe a legitimate pain you can experience. I believe this is mostly due to a historical denial of the mind-body connection in the west. Or rather it is a remnant of that understanding in our current lexicon. A sort of historical iceberg encoded into modern idioms. Since the Japanese have a word for this ailment I think it is important that we incorporate it and decidedly start treating it.

What is unique in the discussion of Katakori in Japanese culture versus the phrases in the west is that a person in Japan could go to their physician and say that the pain in their neck was Katakori and the

physician would understand that until their emotional state clears they will continue to have pain. That until the person takes time to relax, process their emotions, get away from work, or talk to a counselor no amount of treatment will truly help. This validates our emotional bodies. In the west if you told your doctor that you were having neck pain because you are so frustrated with your boss they would likely hear you but would not have any other way to engage with you about that. And because historically in the west we have tried to keep the emotional body separate from the physical body there is truly not a way to engage with this from their perspective.

As the range of symptoms is very broad and essentially covers all possible complaints stemming in and around the neck one would assume that more literature would exist about this common complaint. Rather I believe this has been a long neglected discussion within our field. This paper is an attempt to further examine Katakori and illuminate differential diagnostic patterns. Thus providing clearer pathways to successful treatments for practitioners and patients alike. People identify with ‘their’ katakori as causing a myriad of symptoms and coming from wide ranging set of circumstances. Whether it be their boss working them late, studying too hard, or their mother in law coming to visit. However the ‘cause’ does not always show us what the pattern will look like. That seems to be determined by the patients constitution.

My Japanese patients have described to me getting katakori from their mother in law being in town to their boss working them overtime. There is a since of emotional strain that is tied into this physical discomfort. It is not just a pain that is idiopathic. It is directly tied to an event. I have begun to talk about this as any time you are taking care of someone else’s emotional needs more than you are taking care of yourself. Rather whenever you are ignoring your own state of wellbeing for someone or something else.

Students can get it from studying for too long, lovers can get it from quarreling, paralegals can get it from unrealistic deadlines set by their attorneys, and people can get it from standing out in the wind and the rain. It is not that my non-Japanese patients don’t have Katakori it is just that they don’t have the language to accurately describe their complaint.

One of the aspects to Katakori that I want to make sure I highlight is that it is not just pain in the neck and shoulders. That it is specifically pain in the neck and shoulders that is made worse with emotional distress. This emotional distress can be from any emotional excess. Not just negative stress either but from something like being overjoyed. An acute injury is not enough to cause Katakori. However that acute trauma can also take time to recover because of a persons emotional patterns in relationship to their body. Acute injuries can also grow into a Katakori.

We sit at a curious junction in history. One where East Asian Medical practitioners are trained both in western anatomy and eastern anatomy. This dichotomy allows for us to treat both the branch and the root of an illness with different intentions. One where the practitioner is simultaneously using ah-shi points to release a trigger point in a specific muscle group and also encouraging their patients to make constitutional changes to their diet or exercise routine. The proposed pathomechanisms in this paper are not meant to be a defining list but rather an open ended discussion resulting from my clinical experience. Each respective pattern can be effected by the usual pernicious influences, deficiencies, and excesses.

LOST IN TRANSLATION

Language and translation is a tricky subject. Because some things are able to be directly translated or converted. Yet others are tied to the history of a language, culture, pop culture, phonetics, and the myriad of uses of a language. It is not just alliterations and poetry that don’t translate very well but the meat and potatoes of every language that just don’t line up.

I believe that because of this Chinese Medicine is often excoticized or made magical. These translations lead people to describing qi as energy and the meridians as some sacred river. What I would like to present you with is that the language of ‘qi’ and the descriptions of the bodily functions are no more mystical than biomedicine. They are descriptions based more on the felt experience of the bodies physiology than they are of the bio-chemo—mechanics of it.

Addressing Katakori immediately validates the experience of being human. Of having emotions and having physical discomforts that come with it. And this is where we come in. As East Asian Medicine Practitioners we sit at an interesting crux; one between the experiential and the observable. Due to the nature of western culture we are pushing harder and harder into the realm of the observable. Trying to create studies that show efficacy and create hard data demonstrating our value. I don’t think we must be mindful that this does not undermine the experiential aspect of our medicine. We have to remember to include not just data but the persons experience in our observations. To remember that our treatments interact with the body in all its complexity. One of the strongest aspects of our medicine is in its open ended descriptions of symptoms and patterns. To learn east asian medicine you are learning a poetic language that describes the experience of having a human body. Running piglet qi is the perfect example of this. In western language you may say that a person is having a vagus nerve response. This however does not capture the experience in the same way that running piglet qi does. The sense that something is slippery, rapidly, fluttering up your center. That is excitable and rather uncontrollable. Demonstrating that there is value to the experience of the person and their body.

I think we are at a ripe time to start having these discussion both with patients and with the medical community at large. It is similar in the experience in our communities that until we started to name the sexism and racism that has been pervasive in our society we were unable to address it. The same is true of these emotional pains that we all know and experience to be true but do not personally or culturally validate. We all know the experience of that deep pain in the chest from heartache (if you don’t know it - lucky you), or the nervousness that generates running piglet qi, or the butterflies in your stomach. We all know the experience of emotions physically changing our body. However it is not always accepted as a ‘valid’ experience. As if these emotionally states are not part of the human experience but rather a weakness that we must apologize for.