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Analysing and Interpreting Dreams According to Worsley Five Element Acupuncture

by Janice MacKenzie

Traditional Chinese Medicine has been studying dreams for more than 2,000 years, and holds that dreams are connected to the 5 internal organs and reflect the condition of those organs. The ancient Chinese believed that dreams were strong indicators of the state of balance in the body, mind and spirit.

In the ancient text “Huang Ti Nei Jing Su Wen,” or “The Yellow Emperor’s Classic of Internal Medicine” (written around 200 B.C.), specific dreams pointed to an imbalance in a specific organ, for example: “Fullness of the lungs produces dreams of sorrow and weeping.” (Veith 1972, p. 163).

And from another translation of the Nei Jing: “When the Heart is weak, one dreams of fires; if the dream takes place in summertime, one dreams of volcanic eruptions.”...”When the Liver is in excess, one dreams of being angry.”...”If the Lungs are deficient, one will dream of white objects or about bloody killings.”....”If the Spleen is deficient, one dreams of being hungry; if the dream takes place in late summer, one dreams of building a house.”..”When the Kidneys’ are weak, one dreams of swimming after a shipwreck; if the dream takes place in winter, one dreams of plunging in water and being scared.” (Cited in Maciiocia, 2005, p. 115-163).

These associations are useful, and in practice often do point toward the specific organ or energy needing attention. The traditional philosophy of the Five Elements helps to explain why this is so: each organ is associated with an Element - Wood, Fire, Earth, Metal, and Water - as well as with a season, a colour, a sound, and an emotion. But compared to psychotherapeutic approaches to dreams, this approach is not only very simplistic, it reduces the psychic content of the dream to a physical imbalance in an organ. There’s no attempt to work with the content of the dream in a meaningful way - the dream is simply another piece of evidence that bolsters a particular diagnosis, which will serve as the basis for an acupuncture treatment protocol.

Part of my education before acupuncture consisted of courses in psychology, art, religion, and literature, so I bring to the discussion of dreams a number of different perspectives. Two of the most powerful systems for dream interpretation that I have studied have been Jungian psychology and Gestalt psychology. These two systems have informed my general approach to dream interpretation, but I am not strictly using either Jungian or Gestalt techniques. Much depends on the individual patient, and the patient’s own interpretation of a particular dream. In this regard, I feel I am in alignment with both of these systems.

Jung expressed his attitude toward dream interpretation in this way: “The whole dream-work is essentially subjective, and a dream is a theatre in which the dreamer is himself the scene, the player, the prompter, the producer, the author, the public, and the critic. This simple truth forms the basis for a conception of the dream’s meaning which I have called interpretation on the subjective level. Such an interpretation, as the term implies, conceives all the figures in the dream as personified features of the dreamer’s own personality.” (Jung 1974, p52). He also said, “It is Freud’s great achievement to have put dream-interpretation on the right track. Above all, he recognized that no interpretation can be undertaken without the dreamer. The words composing a dream-narrative have not just one meaning, but many meanings.” (Jung 1974, p70).

Fritz Perls, the founder of Gestalt therapy, had a similar idea. “Perls’ theory of dreams follows the holistic nature of gestalt therapy. Dreams are seen as being projections of parts of oneself. Often these are parts that have been ignored, rejected or even suppressed. One aim of gestalt dream analysis is to accept and reintegrate these.... An important factor of Perls’ theory of dreams is that little if any emphasis is given to ‘universal’ symbols. All symbolism is unique in that it comes from the dreamer and only the dreamer can truly interpret it. In this way gestalt dream analysis does away with the concept of the analyst as expert.” (Mendham 2009, p1).

“For the Gestalt therapist, dreams are to be experienced, not interpreted. Additionally, in keeping with existential philosophy, Gestalt therapists view the dreamer as 100% responsible for all dream images. Specifically, if your client dreams of a terrible monster murdering an innocent victim, both the monster and the victim are considered manifestations of the dreamer....Perls considered dream work to be central to Gestalt therapy. He stated, ‘I believe the dream is really the royal road to integration...’ Moreover, he stated, ‘In my opinion, the dream is much more than wish fulfilment of an unfinished situation. To me, a dream is an existential message. It can lead to understanding one’s life script, one’s karma, one’s destiny. And the beauty of this is that once we take responsibility for our life script, for our dreams, then we are capable of changing our lives.” (Sommers-Flanagan and Sommers-Flanahan, 2004, pp162.163).

What follows is an account of how I have come to look at and use dreams as a part of acupuncture treatment. I don’t feel it is essential that every acupuncturist work with dreams, or that every patient’s dreams need to be interpreted. I certainly don’t think that my way is the only way to do it. I just offer these stories to show how one acupuncturist worked with dreams as a part of the healing process.

First of all, why bother with dreams at all? Primarily, it is to get at a deeper level of your patient’s consciousness -- sometimes, to find out what is really going on in your patient. There are times when I am confused by a patient’s symptoms and presentation, and feel that I can’t make head nor tail out of what is going on -- until they report a dream. Suddenly, the inner conflict is expressed in the poetry of dream language, and as the dream is unravelled, the symptoms and the case begin to make sense to me. So on one hand, the dreams are a way to help in the diagnosis; in the same way that the pulses give you a look at deeper processes within the body, the dreams give you a look at the deeper processes within the mind.

However, another important use for dream work in the treatment room is its ability to shift the discussion from being purely about physical symptoms to being about the evolution of the individual. The dreams will display in colourful images the conflicts and stuck places in the patient’s psyche; discussing the dreams will show the patient how these conflicts and stagnations are reflected in the physical symptoms that they have. It is a way to make very clear the mind/body connection -- and sometimes it is only through seeing this in their own dreams that a patient will come to see that connection.

The best way to show how this works is to give examples. I will start with one of my favourite “dream stories” -- a case where a dream helped in the diagnosis and actual choice of treatment -- and then the rest of this article will be organized by element, with dreams and interpretations categorized into one of the Five Elements. Some of the stories emphasize the dream as an aid to the practitioner in diagnosis and treatment; others emphasize the dream as a tool to discuss the patient’s inner process. Where it seems important, I also discuss the actual points used and my rationale for using them.

Along the way, I will be using some terms that the reader may not be familiar with if he or she hasn’t been trained in Five Element acupuncture. The most important term I use is “Causative Factor,” which has been defined as that one Element of the Five Elements (Wood, Fire, Earth, Metal, Water) which is: “ the primary ‘causes’ other Elements to become imbalanced.....It is the main focus of the [Five Element] practitioner’s diagnosis and much of the patient’s treatment is centred on it. Because it is the patient’s most underlying imbalance it creates much of the imbalance that can be detected in other Elements.”(Hicks, Hicks and Mole, 2004, p. 18).

Richard - Water

Richard is a man in his mid-thirties, a Wood Causative Factor (C.F.) with a lot of professional stress and a history of burn-out, hypoglycaemia and urinary frequency. He tells me the following dream: “I’m on a short vacation. Several people, including me, are fishing in a rapid stream flowing out of a fireplace in a living room, perhaps in Scotland. I try to catch a fish in a way that makes the person next to me unhappy. Two people get salmon, one about 2 feet, the other over 3 feet. Then suddenly the flow of the stream dies down and it’s calm. The tide has changed. I ask when it will start up again and they say in about 4 hours, at 5 o’clock. I’m not sure if I can come back then or not. I think vacation’s ending.”

I thought it was significant, in light of this dream, that Richard had very weak Kidney and Bladder pulses. Although I had been treating him primarily on Wood (Liver and Gall Bladder) meridians, this treatment was taking place in early December, so I decided to treat his Water energies as the Mother of the C.F. and for the seasonal transition. I interpreted the stream flowing out of the fireplace to be a metaphor for his Kidney energy (and, by extension, the source of all of his energy) flowing out of Ming Men. Suddenly, the flow of the stream dies down - but he is told it will start up again at 5 o’clock in the afternoon -- the hour that the Kidney energy comes into its peak! Sometimes, a deficient patient will experience exhaustion for most of the day but will “pick up” during the hours when the Universal energy is highest in his most deficient meridians. After listening to this dream, I knew I had to treat the Kidney meridian in this patient, and the point that was calling out was Fu liu, Kidney 7, “Returning Current.”

Andrea - Wood

Andrea realized after a treatment on 6/23 that her energy was suppressed under her anger - that when she was angry, she felt a lot of energy and her mind felt sharp and clear. So her treatment that day included the points Da dun, Liver 1, Zhang men, Liver 13 and Qi men, Liver 14, to free up the Wood energy, and Nei guan, Pericardium 6 to help circulate the Qi. At the following treatment, she reported this dream:

“After the last treatment, I had a dream - it was really just an image - of a beautiful tree. It came up [here she gestured with her hands] and the trunk was twisted. There were no leaves - it was just the shape, the bark - like in wintertime, it was just brown. It was just a beautiful, ornamental, twisted tree.

She also reported two other incidents of note since her last treatment: she got a speeding ticket, and contrary to her usual response to this situation, she was angry and challenging to the policeman - to such a degree that he gave her 4 points and she has to go to traffic court! She reported feeling really frustrated and angry about the ticket, and impatient with the officer for taking so long to write it up! She couldn’t understand why he didn’t give her any break - especially since she had not had a ticket for over 10 years previous to this. But she realized that he didn’t like her attitude, that she was annoying him, and so he “threw the book at her!”

She also had spent some time at her sister’s place, and she has a lot of envy and resentment for all that she feels this sister has that she doesn’t have. She said, “I go into a deep hole” - and ends up feeling depressed.

The treatment this day included Tong zi liao, Gall Bladder 1 and Zu lin qi, Gall Bladder 41 - I wanted to open and clear the whole length of the Gall Bladder meridian so that she could “see straight” and have perspective - so that her Wood would not be “twisted.”

Davie - Wood into Fire

Davie is a youthful looking 61-year-old man who is in terrific shape - he grows his own vegetables, does yoga and meditates every day - except for the fact that he has a hereditary heart defect that gave him congestive heart failure at an early age. He has had several surgeries to try to improve his heart function, and his medical history is very complicated. His file is inches thick with copies of medical tests and reports he has had done just since I’ve known him. He has been in my practice since April of 2005. In March of 2007, he underwent surgery to have his aortic valve replaced, his pulmonary valve replaced or patched, and his mitral valve replaced. This was a very complicated surgery and he had a very rough time in the hospital and during recovery, with serious complications including being allergic to one of the pain medications and a lot of excess bleeding. After a few treatments, he was his old self again, and by June he was back to working full time. By November, his surgeon said he was doing “amazingly well” - although Davie was still frustrated by some shortness of breath that he thought should have been corrected by the surgery. Davie is definitely a Wood CF, with a tendency for his Liver and Gall Bladder energies to be excessive and flare up into anger, irritation and frustration. After a treatment on November 29th, he reported the following dream:

“I had a wood-stove dream. The wood stove had no damper - I couldn’t shut it down, and it was burning full force. There was nothing I could do. There was nothing to control the fire.”

He then reported not being “in the best mood - not patient.” that week. Since it was early Winter and the beginning of the Water season, I treated some Water points to help control the Fire within his Wood. The treatment that day was Tai chong, Liv. 3 and Qi men, Liv. 14, Qiu xu, GB. 40, Nei guan, Per. 6, Tai xi, Kid. 3 and Zhi yin, Bl. 67. Following this treatment, he came in the next time and reported that his dreams had changed, and were now more about Water. In one dream, he was at the “source” - taking a trip down from the source of the Ganges River, like in Hindu mythology. I thought this was amusing, since Tai xi, Kidney 3 is the “source” point of the Kidney pathway. and is called “Greater Mountain Stream.” Also, since the Water energy is the Mother of Wood, it is the “source” of energy for his Wood element.

This time, the treatment was Zu lin qi, GB. 41, Tai chong, Liv. 3, Zhong feng, Liv. 4 and Qi men, Liv. 14, Jian shi, Per. 5, Zu tong gu, Bl. 66 and Da zhong, Kid. 4. At his next session, he reported that he had a dream in which the outside of his house was on fire, and that he was throwing water on it. He also reported a lot of stress at work that week, including a problem with a volunteer who had a very negative attitude. He concluded that his dream was telling him that “things were heating up” and that he was ready to express himself in a heated way, so he needed to “throw some water on it” to keep from getting angry with this volunteer.

Sally - Fire

Sally is a 40-year-old woman who is trying to become pregnant for the first time. She has a history that includes being the child of alcoholic parents, some sexual abuse by her older brother, and a divorce following her husband’s infidelity. She is currently in a long-term relationship but is not married. I have diagnosed her as a Fire CF, with Heart Protector being the primary Official. Physically, she has very painful periods, and has been diagnosed with mild to moderate endometriosis. Her Wood pulses were very wiry, her lower Jiao was very cold, and she had a lot of pain

upon palpation of the lower abdomen. After her first treatment with me, which included Tai chong, Liv. 3, Qi men, Liv. 14, Nei guan, Per. 6, and Zhong ji, CV 3, she had the following two dreams:

1) “It was about my connecting with Denzel Washington! We were both good friends, knew each other forever. We were dating - it was a sexual thing, but there was no sex happening. I was just leaning up against him, hugging and laughing together.”

2) “I was with a tall, thin, African-American man, and we were dancing together, it was like at a wedding or something - not our wedding, but somebody else’s wedding, and we were guests. And it was like in a movie where the people are in the centre, and the camera is going around them, showing them swirling and in motion. And I felt so in love with this man. And then he kissed me - and I felt shocked! I suddenly knew I shouldn’t be with him - that it was all wrong. And I woke up.”

We discussed these dreams, and I put forward the idea that these two male characters were her masculine archetype, and actually parts of her own psyche, personified in the dream. Suddenly, she made the connection to something a friend had said, upon seeing her house for the first time - that she saw a lot of Sally’s husband in the house, but nothing of Sally - that there was no feminine energy in the house. And Sally realized that she herself is very masculine in many ways, and isn’t really connected to her feminine side. So the dream, she realized, was showing how much in love with her masculine side she is, and yet it is all wrong somehow - especially now that she is trying to get pregnant. After this discussion, I did an AE tap, which on the most superficial level is a slight sedation of the back/yang points, and tonified Shen men, Heart 7. I now know that I need to keep supporting the Yin energies in Sally, not only on the physical/energetic level, but also on the emotional level.

Sarah - Earth

Sarah is a 67-year-old woman in acupuncture treatment for a serious digestive ailment: eosinophilic esophagitis. This rare condition is a severe inflammatory response to an often unknown trigger which causes the throat and oesophagus to swell up and not allow swallowing, and also causes severe gastric pain. A year before she started treatment, she was hospitalized for an acute episode, and had a long recovery from this. With acupuncture, she has done quite well and there is no longer any sign of eosinophils in her oesophagus, but she still has a hard time finding foods to eat that she can tolerate. She is currently on a wheat-free, dairy-free, and gluten-free diet, and is doing very well. She has realized that, growing up, “I lived on wheat and dairy -- I always had bad digestion, even as a child. I was at the mercy of my stomach growing up!”

Energetically, I’ve diagnosed her as a Wood CF, with a chronically deficient Earth, especially on the emotional level. After a recent treatment on Earth (Zhong wan, CV.12, Zu san li, St. 36, San yin jiao, Sp. 6, Zhang men, Liv. 13), she reported the following dream:

“I was lying very still in blackness -- the thought came to me that I was dead. I couldn’t move. Then I heard these words: ‘Whenever I need you, you’re not there!’ I struggled and struggled to get myself up out of this blackness, and I eventually succeeded. Then, in the dream, my husband came into the room, and I told him about the dream. Then I really woke up, and at that moment, my husband was just walking into the room.”

We discussed this dream, and she reported that she thought that her husband must be who she meant when she said “whenever I need you, you’re not there.” I suggested that the dream could refer to other people in her life as well, including her mother -- that the scene reminded me of a small child lying in a crib and not being able to move. This immediately struck a chord in her, and she described how she always had to do everything for herself, that she had to take care of her mother and father growing up, being cute and entertaining them from the time she was a small child -- and that she in fact had to raise herself. She said that she always had to take care of everyone in her life, and never felt the support from her parents, or indeed from anyone. The meaning of the dream for her became crystal clear -- that she always had to struggle up out of the “blackness” all by herself.

After this dream and our discussion, she had to fly to her winter home in Florida for a few weeks -- something which always caused her a great deal of anxiety. She reported at our next session that our discussion of her dream had had a huge impact on her. She was able to fly without being nervous for the first time, and indeed had felt remarkably calm ever since -- as if knowing how unsupported she had been, let her see how the anxiety of that had influenced her life, and that now she did have support in a loving husband, wonderful and supportive grown-up children, and a new-found friend in Florida. Her digestion had also been remarkably calm since then.

Douglas - Metal

A middle-aged small-business owner, feeling the stress of the economy, comes in for a regular treatment. I’ve diagnosed him as a Metal CF, and his primary complaints have been allergies and sinus problems. He is normally in very good health, but recently had an episode of bleeding from the bowel. (He had had a similar episode 10 years previously, which cleared up by itself.) His doctor ordered a colonoscopy, which was performed the morning of the night he had the following dream:

“Elaine (his wife) and I were helping Michelle and Barack Obama to save the world. There was some metal thing taking over the world’s organic material, and it was turning the world into metal. We were in this rainforest environment, and it was just the four of us, but we had a plan to reverse the process.”

This patient had always been resistant to taking acupuncture seriously - he came mostly because of his wife’s insistence. However, when we discussed this dream, and he found out that the colon was considered part of the Metal element in Chinese medicine, he was suddenly convinced of its validity in a way that nothing else had done. He also loved what the dream indicated of his deep desire to do something to “save the world” - to reverse the process of turning a natural rainforest environment into metal, a cold and lifeless material. I suggested that perhaps this was a metaphor for himself - that part of him thought that he was turning into something hard and lifeless like metal, and he needed to reverse the process. My treatment that day consisted of Zu san li, St. 36, Tai bai, Sp. 3 and San yin jiao, Sp. 6, Tai yuan, Lu. 9 and He gu, Co. 4. He had a very powerful treatment reaction that day - unlike his normal reaction which was to get deeply relaxed and almost fall asleep. Instead, he felt his heart racing, his breathing was rapid, and he got a pain in his back -- all of which subsided after a few minutes.

Something about this treatment and the connections we made with his dream seemed to spur this patient’s dream life on to new heights! The idea that these dream images had a deeper meaning and that they related to a deeper process in himself seemed to wake him up in some way -- suddenly he was excited by this taste of self-discovery and the revelation that there might be more to his life than working hard, taking care of his duties and obligations, and making money. He came in for his next treatment with the following six (!) dreams:

1) “I am near death, and having an out-of-body experience. I’m in an operating room, trying to tell them not to stop resuscitating me. I was watching them try to resuscitate me, and they were giving up. They weren’t hearing me.”

2) “All I remember of this one were white limos.”

3) “I remember ferris wheels -- but it was in the future. In the future, you’d have your own ferris wheel and float to the sky, like a balloon. The cities below us were orange.”

4) “I was in a new condo -- it had everything but a bathtub. Then I found the bathtub, but it was filled to the top with white cement, so you couldn’t use it.”

5) “I’m at a museum with many soldiers and the Queen. Instead of looking at them, I am writing a book about the flower, Amyrillis.”

6) “There’s a lake, surrounded by barren hills. There’s a girl swimming in the lake. A helicopter is dropping cars into the lake.”

I thought the first dream was the most significant in terms of the previous treatment -- I had treated Tai Yuan, Lu. 9 -- which has a secondary name or “nickname” of “Corpse Reviver.” Clearly, he wants to be brought back to life, and is afraid that “they” won’t hear him and won’t keep resuscitating him. I took this as a strong message to myself, as the practitioner, to keep on this track of supporting the Metal.

Then, in succession, he dreams about white limos (white is the colour of Metal); ferris wheels (metal) which float to the sky (the Heavens - the Lungs “receive the qi energy from the Heavens”); a bathtub filled with white cement; and a lake with a helicopter dropping cars into it (Metal dropping into Water). He also dreamt about the Queen -- just like the original dream about the Obamas, to dream about famous people is usually a Metal sign of needing to associate with people of quality. I knew by these dreams that I needed to keep supporting the Metal, and in particular the Spirit level of Metal.


Janice MacKenzie, L.OM. is an acupuncture practitioner and teacher with over 25 years of experience in the field. She studied at the College of Traditional Chinese Acupuncture (U.K.) with Professor J.R. Worsley, founder of the school and one of the leading proponents of Five Element acupuncture. In addition, she studied herbology with Simon Mills, M.A., a Master Herbalist from Exeter, England, and Cara Frank, L.OM., in Philadelphia. Janice is currently a faculty member of the Acupuncture Studies Program at the Won Institute of Graduate Studies in Glenside, PA. In 2002, Janice published a book, "Discovering the Five Elements One Day at a Time," by Wind Palace Publishing. She currently has a private practice in Perkasie, PA. You can contact her through her website,


Aggressive Energy (A.E.) -- Aggressive energy can be defined as “qi which has become contaminated or polluted “(Worsley, 1990, Chapter 6, p. 175). This contamination is usually present in one or more of the Organ/Officials, and is usually seen in organs across the ke cycle from each other. It manifests as signs and symptoms of imbalance in these two organs, and represents a pattern of blocked energy between these two organs. When Aggressive Energy is present, the qi can no longer flow in a normal way, and conventional treatment will have little effect.

A.E. Tap - This is a treatment to address the problem of Aggressive Energy. It involves inserting needles superficially into the Back Shu points of the Yin Organs and leaving them in for approximately 20 minutes, until any erythema which develops has cleared. Once the erythema has cleared, the blocked energy between these organs has also been cleared, and the qi can once again flow in a healthy way around the Sheng cycle.


1. Veith, Ilza (Trans.). (1972). The Yellow Emperor’s Classic of Internal Medicine. (First Paperback Edition). Berkeley: University of California Press.

2. Maciocia, Giovanni. (2005). The Foundations of Chinese Medicine (Second edition). London: Elsevier - Churchill Livingstone.

3. Jung, C.G. (Translated by R.F.C. Hull). (1974). Dreams. (First Princeton/Bollingen Paperback Edition). Princeton: Princeton University Press.

4. Mendham, Trevor. (2009). Fritz Perls’ Theory of Dreams. [online]. London: Trevor Mendham. Available from: [Accessed 4/10/09].

5. Sommers-Flanagan, John and Sommers-Flanagan, Rita. (2004). Counselling and Psychotherapy Theories in Context and Practice: Skills, Strategies, and Techniques. Hoboken, NJ: John Wiley & Sons, Inc.

6. Hicks, Angela; Hicks, John; and Mole, Peter. (2004). Five Element Constitutional Acupuncture. London: Elsevier - Churchill Livingstone.

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