As an acupuncturist who is also an Enneagram teacher, I’ve found myself uniquely positioned to study how the ego plays a central role in health. I would like to share with you the kinds of scenarios going on in real life, and how having insight about their own inner workings allows patients to make new choices and embrace vitality. And meanwhile it is also my private hope that this will serve to demonstrate how powerful holistic healthcare can be, and inspire other healthcare practitioners to use the Enneagram in their medical practice as a vehicle to deeper healing.


A fit, attractive woman age 24 came for treatment for chronic low back pain. It had been going on for the past 8 months with no relief. She had seen several doctors, a chiropractor, a physical therapist and a massage therapist with no real change. No one could identify the source of the pain, as there had been no initial injury and her health appeared normal, and no one could seem to resolve it either. She was now trying acupuncture out of desperation.

My first appointment with a new patient is two hours long, allowing the time needed for identifying her personality type, taking her health history, assessing her physically, and administering the acupuncture treatment. In that time I learned several key factors. First, that she was a Type One. With just a couple more probing questions about her high standards and unforgiving thoughts towards herself, I learned she had a history of anorexia and bulimia, now resolved. She also experienced chronic constipation, having a bowel movement only once every 3 days. And finally, I observed how rigidly she held herself upright, often holding her breath without realizing it. I asked her if she experienced much anxiety, and she said Yes, specifically around getting all her “shoulds” done every day.

Type Ones are interesting patients because they are so compliant, willing to follow their doctor’s instructions to the letter. They eat the right foods, take the right vitamins, and exercise the right amount. Yet their health is often problematic. What they cannot see is how their own ruthlessness with themselves impacts their psyche and their health.

I spent some time doing breath work with this patient. This helped her see for herself how, when she was stressed or thinking negative thoughts, her diaphragm closed and her body became rigid, leading to shallow breathing in the chest only. But when she was relaxed, she was able to descend her breath all the way down into her belly, and her exhale became cleansing and complete. I told her I felt her constipation was connected to both how rigidly she held her body and her incomplete breaths.

I advised she try some Smooth Move herbal tea to get her bowels going. A healthy bowel pattern is a minimum of once per day—it is essential to clear toxins out of the system daily. Also, I gave her a small meditation exercise to practice at home. Every night in bed, before she went to sleep, I advised her to practice deep breathing, breathing all the way in for a count of 4, holding it for 2, and then fully exhaling for a count of 6. She should do this for 10 repetitions, meanwhile saying to herself: I like myself the way I am. I gave her an acupuncture treatment and she left feeling relaxed and pain free.

I was surprised a few days later to receive her voicemail cancelling the next appointment. I thought we had had a positive connection and was disappointed she did not want to continue treatment. I waited a few days hoping she would call to reschedule, but she didn’t. The following week, I decided to call and check in.

She told me that the reason she had cancelled was because her back pain was now completely gone. After our first treatment it never came back. She thanked me profusely and said she would be sending me referrals. Here is part of the testimonial she wrote for me:

With this consultation and acupuncture, not only does my body feel good but my mood seems much better and I almost have a different outlook on life. My issue was serious emotional strain, realizing that has made me consider a new way of thinking and action. It is amazing! Never had such a positive experience and before I was even skeptical about the therapy as a whole, and if it truly did any good. I highly recommend this therapy above all others at this point.

As much as I would love to claim that acupuncture cures pain in one treatment, that is typically not true. Our general guidelines are that for every month you have had the pain, you will require about a week of acupuncture. With youth this is often shorter. So I would have expected her to need about 5 treatments over a month. I think what really resolved this patient’s condition so quickly was her quick realization of how often she thought critical angry thoughts toward herself, and how this caused her to hold her breath, leading to constipation and rigidity in her body. By noticing ourselves, we are able to intentionally shift our thoughts, easing our body into a state of relaxation and healing.