Dr Im Quah-Smith: Can Laser Acupuncture Aid Depression Therapy?

Dr Im Quah-Smith is a medical practitioner and independent medical researcher with a focus on optimal wellbeing, preventative medicine, and stress management. After many years in general practice, Dr. Im Quah-Smith developed her interest in mind-body medicine where she observed the effects of environmental stressors on physical symptomatology in patients. In our conversation, we explore acupuncture, posturology, auricular medicine and her emerging research on how laser acupuncture might aid depression therapy.

Health Podcast Highlights

Dr Im Quah-Smith: Can Laser Acupuncture Aid Depression Therapy? Introduction

Acupuncture is an area of medicine that we’ve all heard about, and I must admit I know very little about it. So when I heard of the wonderful guest that I have today, I could not resist inviting her on to share with us her knowledge in this area. And what I learned was even more than that, I learned terms about Auricular Therapy, well, Auricular medicine. 

Auricular referring to the medicine that surrounds the ear. Yes. You’ll hear more about that. Posturology, another term I hadn’t heard of, although I’ve certainly been focussed on posture and that was an interesting term and approach as well. And also the work with lasers which I, myself, have been using in my practice for some time. But so interesting to hear the latest and the greatest use on that.

My guest today is Dr Im Quah-Smith. She is a medical practitioner and an independent medical researcher with a focus on optimal wellbeing. She’s constantly exploring and refining protocols for improving health outcomes. Dr. Quah-Smith developed her interest in mind-body medicine during her many years, in general, practice where she observed the effects of environmental stresses on physical symptomatology in patients.

In 2000. In the year 2000, Dr Quah-Smith sub-specialized in medical acupuncture and she shares that journey with us today. And she is, of course, a Fellow of the Australian Medical Acupuncture College (AMAC). Further acupuncture studies were undertaken in Lyon, France, the home of modern ear acupuncture or auricular medicine, under Dr. Raphael Nogier.

Merging her knowledge on acupuncture in Traditional Chinese Medicine and her neuroscience study in acupuncture, Im has developed strategies in healing and maintaining wellbeing in the individual. She holds a Master’s Degree in Family Medicine and her PhD was on Laser Acupuncture in Depression, where she expanded the evidence base using functional MRI — Magnetic Resonance Imaging. She shares a lot of that with us today. I hope you enjoyed this conversation I had with Dr Im Quah-Smith

Podcast Transcript

Dr Ron Ehrlich [00:00:00] I’d like to acknowledge the traditional custodians of the land on which I am recording this podcast today, the Gadigal people of the Eora Nation, and recognize their continuing connection to the lands, waters, and culture. I pay my respects to the elders of the past, present, and emerging.

Dr Ron Ehrlich [00:00:24] Hello and welcome to Unstress. My name is Dr Ron Ehrlich. Now, Acupuncture is an area of medicine that we’ve all heard about, and I must admit I know very little about it. So when I heard of the wonderful guest that I have today, I could not resist inviting her on to share with us her knowledge in this area. And what I learned was even more than that, I learned terms about Auricular Therapy, well, Auricular medicine. 

Auricular referring to the medicine that surrounds the ear. Yes. You’ll hear more about that. Posturology, another term I hadn’t heard of, although I’ve certainly been focussed on posture and that was an interesting term and approach as well. And also the work with lasers which I, myself, have been using in my practice for some time. But so interesting to hear the latest and the greatest use on that. 

Dr Ron Ehrlich [00:01:23] My guest today is Dr Im Quah-Smith. She is a medical practitioner and an independent medical researcher with a focus on optimal wellbeing. She’s constantly exploring and refining protocols for improving health outcomes. Dr. Quah-Smith developed her interest in mind-body medicine during her many years, in general, practice where she observed the effects of environmental stresses on physical symptomatology in patients.

In 2000. In the year 2000, Dr Quah-Smith sub-specialized in medical acupuncture and she shares that journey with us today. And she is, of course, a Fellow of the Australian Medical Acupuncture College (AMAC). Further acupuncture studies were undertaken in Lyon, France, the home of modern ear acupuncture or auricular medicine, under Dr. Raphael Nogier. 

Dr Ron Ehrlich [00:02:18] Merging her knowledge on acupuncture in Traditional Chinese Medicine and her neuroscience study in acupuncture, Im has developed strategies in healing and maintaining wellbeing in the individual. She holds a Master’s Degree in Family Medicine and her PhD was on Laser Acupuncture in Depression, where she expanded the evidence base using functional MRI — Magnetic Resonance Imaging. She shares a lot of that with us today. I hope you enjoyed this conversation I had with Dr Im Quah-Smith. Welcome to the show, Im.

Dr Im Quah-Smith [00:03:00] Thank you, Ron, for inviting me.

Dr Ron Ehrlich [00:03:02] Im, it’s a pleasure. I know you’ve been in practice for a few years now, and there’s so much today that I wanted to talk to you about. But I wondered if you might just share with us your professional journey to this point.

Dr Im Quah-Smith’s Journey

Dr Im Quah-Smith [00:03:14] Well, in short, I was doing general practice at Lingfield in a group practice, and Tim Remillard was one of the principals invited me to join him to learn Acupuncture at North Shore Hospital. And I looked at him and said, “Well, what’s it good for?” Because a lot of people just assume because I’m Chinese that I would know all about it. And having grown up here, it was completely foreign to me. 

And I said, well, if it’s going to be good for pain, as Tim promised me, will be helpful for the patients, I went along with him and we both and did some weekend, several weeks in a row and learned how to run it practically and understand the Chinese Medicine aspects behind it.

Dr Im Quah-Smith [00:04:00] In 1991, it was quite rudimentary what we know about acupuncture now we are up into the cell precursors, research, and all that. A long way down the track. And I tried it out on my patients in general practice. For a couple of years and I thought, “Oh, when it works, it works really well.” And when it doesn’t work you go, well, “What’s the point?” And I figured I couldn’t just follow some cookbook recipe that someone told me I had to do for arthritis or pain or menorrhagia or whatever it is, or insomnia. I need to figure it out for myself. How best I can sort it out?

It was around the 2nd or 3rd year into acupuncture, I realized you have to tailor-make this to every individual and everybody comes to that point when they come and see you with a different set of past history. So you can’t just use one strategy, one template for everything.

Dr Im Quah-Smith [00:04:55] And that’s when I thought I should try to hone my skills and merit to my scientific mind more by doing a Master of Family Medicine. Where I used acupuncture, laser acupuncture in depression, actually, as a research project with Monash University. So we had excellent findings there. 

And then I replicated the findings when I did my PhD. And this time around, we not only had the clinical study, but we also had the neuroimaging, the functional MRI evidence to show what actually goes on in the brain when you intervene in multimodal depression using laser acupuncture. So that was really good to be able to replicate your experiment and to actually show at the brain level. How amazing the correlation is.

Dr Im Quah-Smith [00:05:42] And I have naturally always been interested in people, counseling started off with Paediatrics and Women’s Health, and then you get into the whole thing just grows. That’s where I am now.

Dr Ron Ehrlich [00:05:54] Well, listen. Let’s start with acupuncture, because, you know, whether you have a Chinese background or not, we all hear a lot about acupuncture for various things. And I wondered if you might just give it to us to sort of acupuncture 101. How does it work? What’s the general concept?

How does Acupuncture work?

Dr Im Quah-Smith [00:06:13] Okay. Well, Ron, I think people would expect me that at this stage to talk about channels and acupuncture points. But you can read that in so much literature, so many other podcasts with other people. But I come along speaking as a medical acupuncturist. So my skills, medicine, and I’ve got a good understanding and I practice principles of Traditional Chinese Medicine. 

I’ve got some Iveta behind me as well. And also now, well, thanks to the University of New South Wales, have a good understanding of neuroscience. So I almost have a triangulation when I see a new patient, I can see it from different aspects of the patient. And then I home in on the root cause or the origin of the problem and work from there

Dr Im Quah-Smith [00:07:00] So I kind of think of myself as, you’ll laugh at this, a human electronics engineer. Because when you work as an engineer, you’re working in systems biology. You’re trying to figure out what went wrong there, what supply situation went missing, supply, demand, delivery, and being able to restore every single one of those aspects so every cell functions optimally again. 

And usually, when cells go off, it could be because of an infection or a persisting infection. It could be from the shock. It could be from traumatic brain injury. And the old-fashioned way to call TBI is post-traumatic stress. It could be from pure neglect, burning the candle at both ends, eating badly, drinking too much, not getting enough sleep.

Dr Im Quah-Smith [00:07:47] And of course, with 2020 behind us and the whole COVID experience still pretty much with us and around the world, collective anxiety. So all these things can disrupt what is going on with the body.

And I think, not in terms of channels or acupuncture points, I just think of the brain and body communicate with each other in an extremely elegant and very interesting, complex electrical wiring kind of way. 

So we’re talking about how it’s sort of like a 3-D information freeway. So it’s not a linear system where point A in the brain talks to B in the body, C down the leg, or whatever. And then it goes down EFG back up to the brain. It actually is far more complex, more three-dimensional. So everything pretty much happens at once.

Dr Im Quah-Smith: [00:08:42] So it’s like a 3-D electrical grid. And we are aiming for optimal signaling between every aspect of the brain and body communicating with each other. And there will be sections of the brain and sections of the body where it’s like an interchange as such Chatswood interchange, you live in Sydney or Bondi Eastern Suburbs, Bondi interchange where there’s a lot more activity, there’s a lot more transport exchanges happening, and those areas have faster response, faster freeway movement and then out in the periphery, they’ll be slower movements, slower communication. 

But the main aim is to figure out when all these possible insults to the brain and body happen, where the glitches are or where the traffic jams are, where the short circuits are, and to re-establish it.

Dr Im Quah-Smith [00:09:38] You can do that with needle acupuncture because we know this a huge amount of functional MRI. And while mostly functional MRI experiments up there, starting with Sang Hei Cho back in 1998-2000, showing that when you tinker with acupuncture points in the legs, particularly stomach 36 or spleen six, these points trigger a response in the midbrain. And from there the signals then go to various parts of the brain which need some readjustment or rehabilitation. And then the signals would then go back down to whichever part of the periphery that needs a correction.

Dr Im Quah-Smith [00:10:20] Functional MRI has been the most wonderful thing for acupuncture because before that everyone was very stuck in spinal cord work and about how it’s always about pain pathways. And actually, it’s way, way more than that. There’s a lot of autonomic nervous system reregulation, and I think that’s even far more important than just spinal cord or call them two to five activation or reregulation that happens when you do acupuncture.

Dr Im Quah-Smith [00:10:49] When it comes to acupuncture, to the different modalities. The traditional, of course, is acupuncture needles, which, by the way, aren’t sharp. I have to tell the audience everyone’s terrified of being punctured and sounds dreadful. But if you look under an electron microscope, the tip of the acupuncture needle is actually rounded.

Dr Ron Ehrlich [00:11:08] Oh, hmm. That’s reassuring.

Dr Im Quah-Smith [00:11:10] Very rare these blood come through unless you’re scratching the surface on purpose or boosting a capillary as you pull the needle up in a rough way or something. But it’s actually highly elegant and it’s a bloodless feel, it’s non-invasive and it’s really not meant to feel pain. It’s meant to feel like a little tweak or a low-grade ache if you’re doing it correctly. 

Dr Ron Ehrlich [00:11:32] Hmm. Okay.

Dr Im Quah-Smith [00:11:32] And for those of you out there terrified of needle acupuncture, please be assured, they’re not really needles. They actually have round tips and it goes through the pores. Then it’s a very gentle, elegant, refined process.

Dr Ron Ehrlich [00:11:44] You’ve made that sound so appealing. You know, I can’t wait. And I have, I know this is odd, but as a dentist, I have a needle phobia. It’s one of those things that’s better to give than receive. I love your description of yourself as a human electronic engineer, because one of the things that I think we all, as health practitioners, let alone as the public need to be aware of, is we are walking electricity.

Absolutely. We are. Well, that is how anything works, whether we’re talking about a single cell or the whole body, it’s all the microcurrents that drive us.

Dr Im Quah-Smith [00:12:23] So when you do a treatment and acupuncture treatment and you tailor-make it for the individual, you will create some of these shifts you require to have much better signaling between the brain and body and to restore functionality. But the brain is a bit of a lazy pupil. This is my understanding after being a doctor for 40 years and having done acupuncture and laser acupuncture for 20 years.

It’s a bit of a lazy pupil and I kind of understand it because of working with neuroplasticity. And if you want to imprint a signal, you have to do a repeated signal until it consolidates. It’s not going to remember when I do Posturology, I’ll tell everyone your pain in your back, your muscles, your head shoulder thing will improve for probably one and a half, two days. Then we’ll go back to square one. But the more I put in a signal, the more the remember for a longer time period.

Dr Im Quah-Smith [00:13:18] Yeah. So we need the consolidation. So if people wonder why they have to keep going back for a few sessions, it’s because you’re trying to consolidate a change in signals like learning, it’s a good analogy that if you’re going to take up piano playing or you’re already a good piano player and you’re learning a new piece, you’re not going to be good at it in the first one, two, three, four times. You may get better at it at the sixth time. And certainly, by the time you played it 12 times, you’d be pretty good. Yeah, pretty good.

Dr Ron Ehrlich [00:13:50] But you were mentioning that there are different modalities and the, I don’t even want to call it a needle — the rounded, gentle probe that goes through the pores.. well, we’ll call it needles. Done.

Dr Im Quah-Smith [00:14:03] We’ll call it needles, the WHO expects it to be called needles. 

Dr Ron Ehrlich [00:14:07] So that’s one modality. But there are others, aren’t they? Well, tell us about some of the others.

Dr Im Quah-Smith [00:14:12] So you can do Acupressure. So you’re taught how to massage, get the lymphatics in the right direction, or which way you want to move to stimulate in whichever direction. And there’s a complex another lecture in itself there.

But so Acupressure is one. You can put magnets in the ears. This is a really beautiful topic, I’ll talk about it later. You can put magnets on parts of the body because when you put some sort of stimulation, whether it’s a stimulating electromagnetic field. If we are all electrically wired, every single electric current would have an EMF, as we know. So when you use magnets on the body, you are actually making a signal change or clearing a signal block or short circuit using the magnet.

Dr Im Quah-Smith [00:15:01] The other modality that some people use and certainly in Australia, we use Laser Acupuncture, which is therapeutic laser. It’s helpful. I love using laser because laser helps you quantify how tired an area is, how bad the short circuit is, how dysfunctional a site is because you can actually quantify it. 

Dr Im Quah-Smith [00:15:27] And people say, well, “How can you quantify it? Don’t you just put ten seconds here? Ten seconds there?” No, because if you learn something from auricular medicine and I will say American Medicine and not therapy because it’s a whole field standalone, you don’t happen to have to use the word acupuncture. You don’t have to be acupuncture trained to use auricular medicine. 

Vascular Autonomic Signal or VAS

Dr Im Quah-Smith [00:15:47] With auricular medicine. Dr Raphael Nogier, Paul Nogeir, the father of Modern Auricular Medicine in France, discovered this pulse called the Vascular Autonomic Signal or the VAS. It’s sometimes known as the rack. And there’s a whole other names used in Europe. But I think of it as the best. And I’ve done all the research and applied the term VAS.

The Vascular Autonomic Signals (VAS) is a very peculiar thing that Paul Nogier discovered back in the 50s and 60s, probably the 60s. When there’s a dysfunction in the area on the body surface, the radial pulse, this is we can pick it up from any other parts of the carotid or wherever else. But the easiest one is obviously the (inaudible) house.

When you run your hand along on somebody’s or a patient’s skin surface at a longer hand along a fractured rib area. So here’s a classic. I saw a patient today who had a sailing accident and broke two ribs and I didn’t need him to tell me anything. I just looked for where she sits on the right side. So I looked on the right side and I correctly located where the two fractured 8th and 9th ribs were by using the VAS.

Dr Im Quah-Smith [00:17:00] So it picks up on a change in the electromagnetic field because of our electrical wiring on the surface. And when you have a dysfunction like a fracture, there will be a shift in the magnetic field. There’ll be a shift in the electrical signaling there, and you can use the Vascular Autonomic Signal to pick up the location of it.

Dr Ron Ehrlich [00:17:20] And you picked that up by palpating it or with the laser? How did do that?

Dr Im Quah-Smith [00:17:24] No, I just use this Vascular Autonomic Signal. I feel the patient’s radial pulse and check its amplitude. And then I scan my hands, touching the skin surface lightly around the area, which I think the problem is. And you can then home in precisely on where the rib fracture is. And the patient will say “Ouch.” You got it. You found it.

Dr Ron Ehrlich [00:17:47] Right.

Dr Im Quah-Smith [00:17:48] Yeah. So VAS is a wonderful thing, which I think really should be taught in future years, hopefully in Medical School, because it’s such a wonderful tool for you to home in on where the problem is. And it’s even more relevant when you do Auricular Medicine as well.

Dr Ron Ehrlich [00:18:04] Well, that’s.. you introduced me to this term, Auricular Medicine. And I must admit, well, I’m not familiar with it.

Auricular Medicine

Dr Im Quah-Smith [00:18:13] No, it’s not. It’s not heard often in this country. I trained in France. It’s the only reason I’m using it and able to apply it in my research work. Yeah.

Dr Ron Ehrlich [00:18:22] So Auricular Therapy. Tell us about Auricular Medicine.

Dr Im Quah-Smith [00:18:28] Very good, Ron.

Dr Ron Ehrlich [00:18:29] I’ve already learned that. Okay. Auricular Medicine. Tell us about it.

Dr Im Quah-Smith [00:18:34] Well, Auricular Medicine is extremely helpful and its use is hinged on the fact that the auricular surface on both sides so left ear wax on the left hemisphere of the brain, right ear works in the right hemisphere. It’s lateral and the surface of the ear is innervated by the irregular branches of the vagal nerve 4. So the irregular branches of cranial nerve 10 or the vagal nerve 5 which is the trigeminal and the suppressive I call chain.

All these three things innervate the surface of the ear, and from these areas, you can then access a whole range of central functions of brain functions by using the ear via cranial nerve ten, which is usually the conchae or the hollow of the ear or cranial nerve five, which is all along the helix in the mostly the upper part of the ear and quit and then disappear. Several changes somewhat further down in closer to the tragic Nottoway touches your face around that region

So with the ear, when you use parts of it and if you use the Vascular Autonomic Signal, you can figure out which part is in trouble. And when you treat that area, which comes positive or an increased radial amplitude using the VAS, you know then you need to either put a magnet there or needle there or laser there

Dr Im Quah-Smith [00:20:08] And I’ll just elaborate the laser thing a bit. If you use your therapeutic laser and you aim for it, for example, in the conchae you’ll find with your VAS the exact maximal, optimal point to treat, to excess the cranial nerve 10 entry into the brain. And then if you laser it and you count, as in the patient’s pulse, how many seconds it takes for the VAS signal to pit it off.

So when errors and dysfunction like for example, the cranial ten side in the ear and the pulse will become because it is in trouble, it becomes more like a sawtooth wave. And you just keep on transferring light energy, your laser beam into that point, and eventually, it’ll become a sign wave. And, you know, you’ve topped up the region. You’ve corrected the problem because most instance, in synchrony, those things which are running well, it’s usually a sign wave of sorts. And sawtooth wave so when there’s the dysfunctional side.

Dr Im Quah-Smith [00:21:16] So if it takes 57 seconds to change your radial pulse, amplitude, and waveform at the ear then you know your vagal upload time or your VUT are in this, these are things I’ve coined for myself. I use it a lot and I publish a couple of papers on that already. It’s very interesting because then you know, this is the baseline for that particular individual, 57 seconds for whatever the dysfunction is.

Let’s say it’s irritable bowel or it’s post-chemotherapy, liver change result — it’s all vagal linked. And you are trying to restore function. So it took you 57 seconds to rescue (inaudible) the liver or the cranial nerve 10 affected by the chemotherapy or whatever that issue is and you’ve restored it. So then you do whatever you have to do and then the next time you see them at the next session, it might still be there or it could be a lot better. Let’s say 57 second vagal upload time down to 25.

Dr Im Quah-Smith [00:22:21] So, you know, you can quantify the heat in the right direction because empirically I found you need to get vagal upload time down to 15 seconds or less, to have the perfect vagal functionality. But of course, we are living in difficult times. I’ve yet to find anyone get down to ten actually.

Dr Ron Ehrlich [00:22:41] Hmm mm. I have had acupuncture and I’ve always been impressed that the practitioner puts their hand on my radial pulse and says, yes, they can feel this or that. That’s the VAS that you’re feeling. The Vascular Autonomic Signal.

Dr Im Quah-Smith [00:22:53] I’m feeling a singular VAS because the Chinese pulse involves six pulses each wrist, which I do measure that, too, but I’m looking at a wavelength change.

Dr Ron Ehrlich [00:23:02] Right? And it took, say it takes 57 seconds for you to correct that.

Dr Im Quah-Smith [00:23:08] That looks pretty bad.

Dr Ron Ehrlich [00:23:09] Yeah, that was what I’m going to say. What is the range in the… 

Dr Im Quah-Smith [00:23:14] It could be huge. Like I have a patient I saw earlier this year. And what was she? She was early pulmonary fibrosis. So I need to step back and say so the ear, apart from the concha being access to cranial nerve 10 and cranial nerve 5 all the other parts of the ear. There’s also a map of the ear, which I know it’s going to be uncomfortable with anyone with a medical degree to believe but the ear actually has a map of every single organ in the body, including the end up being the new cortex and the and at the into a tragic notch, that region is actually the subcortical region of your brain.

But there are a few functional MRI and other neuroimaging studies to show brainstem. They have been able to represent brainstem to body parts like knees using MRI, stimulating and then picturing it and realizing that it actually goes to that part of the representation in the somatic in the brain department. So they’ve been able to, the French have shown me knee areas and hands areas and the Italians have been able to show brain stem region.

BFA (Battlefield Acupuncture)

Dr Im Quah-Smith [00:24:33] And of course, my colleague and friend, Richard Niemtzow at Andrews Air Base, runs an acupuncture clinic and he’s world-famous for Battlefield Acupuncture. He uses it as battlefield acupuncture, but I tend to think of it as standalone Auricular Medicine because the Battlefield Acupuncture he uses includes the cingulate and thalamus at the ear. It includes, you know, sort of a physiological resetting point in the ear. Five points that you use called BFA (Battlefield Acupuncture) that he uses studs, he punctures studs in.

Dr Im Quah-Smith [00:25:08] What he did was he designed this protocol BFA (Battlefield Acupuncture) for all the servicemen, the military who were injured in battle in Afghanistan and Iraq so that the Medic on the team can get up to the person who’s injured, shot, IED explosion, something nasty like that. Being able to punch in Battlefield Acupuncture points. And that was and then by doing that bilaterally, it was central pain control immediately. Central pain control, so enough that they can pull the guy out of danger without him being in massive pain. And the soldiers know it for themselves.

Dr Ron Ehrlich [00:25:52] I mean, literally a battlefield. Battlefield. And I thought it was a metaphor, but it’s not. It’s literally a battlefield. Yeah, you alluded to the fact that when a medically trained doctor looks at a chart which shows the ear and all sorts of different parts of the body, this is met with skepticism.

Dr Im Quah-Smith [00:26:15] Oh, absolutely. I started my acupuncture with great skepticism myself. You have to start there And then right. The experiment. And sometimes if it doesn’t show, it’s because you probably didn’t have the right design or you didn’t grasp what you’re trying to measure. I think that’s the main thing. And the other thing I learnt as a researcher is never leave any stone unturned. Just because there’s no evidence now, doesn’t mean in the future someone will not find it for you.

Dr Ron Ehrlich [00:26:45] Yes, yes. Well, when you talk about research, I know you did your PhD in NeuroScience and Laser Acupuncture.

Dr Im Quah-Smith [00:26:54] Yes.

Dr Ron Ehrlich [00:26:54] Can you tell us a bit more about your findings there?

Laser Acupuncture and Depression

Dr Im Quah-Smith [00:26:57] OK, so in our Laser Acupuncture and Depression Project, we ran concurrently a clinical study. So I selected points which were relevant to depression in the Traditional Chinese Medicine sense, and they were similar to the ones that I used when I did the Monash project. And we saw, we had the laser rigged up so that you can’t tell whether it’s a real or fake laser. You just hear the beeping, you see the white light, but the white lights just a point in light. It’s not the laser at all, the lasers, the infrared. So you can’t really tell what’s what.

And we laser at all this depression-friendly points on the participants twice a week for four weeks and then once a week for another four weeks. And we made sure that we got the right Hamilton d-scale for depression that they were all in that range. And then the research assistant took readings in between as well. So we make sure we had self-rated scales and we had to make sure there was a clinician where it had skill as well at the beginning and the end. So we wanted to be absolutely watertight and not miss anything, because one of the things is it’s better to measure many more things and then find what you want than to miss out and think, oh, we should have measured then and it’s too late by then.

Dr Im Quah-Smith [00:28:25] You finished your project and you’ve missed out on measuring something important. So we found that it was highly significant using these acupuncture points for mild to moderate depression and the results correlated with the neuroimaging that we did as well for mild to moderate depression. And because they were quite different findings to that from people who were just controls and not depressed at all.

Dr Ron Ehrlich [00:28:52] Mm-hmm. I mean, it’s not actually surprising, although I haven’t thought of it before, that acupuncture could be used in a positive way to deal with depression. 

Dr Im Quah-Smith [00:28:52] Mm hmm. Because we talked about the mind-body connection here. And it’s you know, we kind of compartmentalize all these things as though they’re separate. Yeah. This is, again, about restoring function, restoring balance. So the interesting thing is that neuroscience and acupuncture are actually just two languages describing the same physiological phenomena.

For example, in acupuncture, say someone is in excess or someone’s deficient or your liver’s excess. In excess, your liver’s deficient. So I’ve got to fix it up with my needle, acupuncture, or whatever. And when you’re talking functional MRI activity or how the brain is going when someone is in excess many areas of the brain and overactive activation mode and when they’re deficient, you can see the anti-activation happen, you put in your intervention for whatever times you have to do it. And then we measure it and you see that that whole over activation crazy fireworks in the brain picture becomes very calm and normal again. Yeah.

Dr Im Quah-Smith [00:30:19] Or if it’s dysfunctional or under activated or deficient, you find this a lot of anti-activated areas. And I won’t go to the, you know, the signs and the colors and all that. And then what happens is with the laser acupuncture and with needle acupuncture, I’m sure, you’ll find that the under activation goes back to normal. So acupuncture per se and even auricular medicine per se, what they do is they tend to correct whatever this dysfunction is. It causes a reregulation and everythings about restoring optimal function. Best possible. Obviously, these other comorbidities, whatever else, so you have to put in the best possible here.

Dr Ron Ehrlich [00:31:03] And the lasers that we’re talking about, they are low energy?

Dr Im Quah-Smith [00:31:08] They’re therapeutic lasers. So the majority of people would have infrared wavelengths and other people would have a red light laser. The other lasers, yellow laser now that are very expensive and hard to find. So what you find that people get access to for clinical care would be infrared and red light lasers. 

Dr Ron Ehrlich [00:31:28] And is that wavelength particularly important? Like is that a very narrow. Well, the infrared is—

Dr Im Quah-Smith [00:31:34] Pardon, the way things are not so important when you’re doing brain work when you’re doing auricular medicine, but you’re doing bodywork and you’re trying to get into a really spasm muscle in period would be better because it penetrates deeper with light, doesn’t penetrate as much. That’s about the only go-home or take-home message you need to know about them.

Dr Ron Ehrlich [00:31:53] I remember using my first low-energy laser in about 1990 and I remember that it was said the reason it worked well was because, A) improved lymphatic drainage and B) improved mitochondrial activity. And when you say to me you’re an electronic engineer and mitochondria is where the electron transport.

Dr Im Quah-Smith [00:32:21] Yeah, exactly. So that would be at the micro-level. I started getting interested in mitochondrial medicine, last year when I was with one of my teachers, Michael Weber, who’s a fantastic expert on mitochondrial medicine. I was actually ahead of the covid in beautiful Kabera, Algarve when we had a week’s worth of mitochondrial medicine workshop. And I learned so much there. And that goes into a field that will take another lifetime to learn, which is, you know, what supplements do you use, etc… I won’t even go there. I’ll leave it to the experts. I will stick to my skill set.

Dr Ron Ehrlich [00:32:59] Another term that I learned when… I was so looking forward to talking to you about auricular medicine in your research around acupuncture and laser was Posturology.


Dr Im Quah-Smith [00:33:10] Oh, yeah.

Dr Ron Ehrlich [00:33:11] Posturology is another word that I was not familiar with. Tell us a little bit about what that means. What is Posturology?

Dr Im Quah-Smith [00:33:18] Okay, Posturology is using regular medicine at the ear and accessing the areas which connect, which then link to the brain department, which is in charge of making sure your whole frame, your head, and your torso and your hips and your legs are all matched up. So you have the same equal pressure landing on the left leg and the right leg to stand on the ground. So equal muscular tension as opposed to one side be tighter or rotated.

Dr Im Quah-Smith [00:33:54] So Posturology repeated that and usually half a dozen sessions is enough to correct that postural change. So anything can go wrong when you have muscles in the back and neck not behaving properly because we have to remind ourselves the autonomic nervous system sits outside the spinal cord, outside the protection of the vertebrae is just sitting just a bit outside. The powerful muscles are just overlying it. So if the muscles are tight, they can definitely irritate the autonomic ganglia and can create a huge a plethora of symptomatology.

Anything from palpitations, panic attacks, anxiety, dizzy turns, butterflies in the stomach, nausea, anorexia, you name it, all these very vagal things. Think of all the vagal symptomatology and they all will activate because you are irritating the autonomic chain wherever the issue is.

So Posturology, when you correct the muscles and the structures, you just help this autonomic system to behave the way they’re meant to behave and to run the body as they should be running the body without any irritation at any time. A classic spot is up here. It’s paravertebral C7, T1 at T one about an inch out. You have the standard ganglia there. And I learned this from in France with Rafael Nogier. And when you correct the posture, you’re relieving the tension, which is such a classic place. Everyone holds that tension and stress up there, particularly you’ve been zoomed working from home and dining room chairs and not proper chairs, a normal workstation. So you can then create all those vagal symptomatologies I’ve just mentioned. By having this problem, there’s the Posturology to correct that.

Dr Ron Ehrlich [00:35:45] Well, you should try being a dentist. That point is, you know, I can react to that. But how do you assess that? Is that just by observation palpation or is it actually on a–

Dr Im Quah-Smith [00:35:59] Oh, there’s a range of things? It’s hard to explain on a podcast, but you just get the patient to stand and you have to observe and see and make an idea of what the differential is and you record it. And then I have to tell you when you do the posture points and you then ten minutes later stand them and measured again is corrected and of course, you go to consolidate, it’s going to be good posture for one and a half days and there’s going to be bad again. Bad habits come back. Yeah.

Dr Im Quah-Smith [00:36:26] So neuroplasticity is the most wonderful thing. It just works so quickly. Just have to consolidate the positive changes. Yeah, that’s my experience.

Dr Ron Ehrlich [00:36:35] And that consolidation, as you were mentioning with the learning of the piano piece or the correcting of a body electric system takes.. well what you’re saying six, ten, twelve sessions.

Dr Im Quah-Smith [00:36:49] I hope for the majority of people it would take about six sessions unless you have a lot of comorbidities and it could be any other reasons why the muscles on restoring their function as quickly as they should have. Yeah, six is very biological number. You should’ve meet some physiotherapy studies or acupuncture studies or Raichlen. You find that six is that. I’m not sure why no one’s ever explained to me why six is the turning point.

Dr Ron Ehrlich [00:37:16] Yes, it may be when we run out of fingers on one hand and we’ve committed to expanding our friend reference. Another term that you used is Somatisation. Tell us about the Somatisation.


Dr Im Quah-Smith [00:37:33] Somatisation is everywhere. All it means is that when your brain is just in dysfunction, particularly the emotional part of the brain, it will then through its midbrain section or the limbic system where physical and emotional pain sits together, your emotional pain turns into physical pain and will go to some of the body parts. So, for example, frozen shoulders or shoulder stuff, sure, you can have a shoulder injury, and then, of course, you get problems and there has to be treated as a shoulder injury.

But sometimes if it doesn’t repair as fast as a consultant or the physiotherapist expects it to or the osteopathic expects it to repair or be back to normal function, it’s because there’s some sort of a somatic element. They’re hiding.

Dr Im Quah-Smith [00:38:24] The shoulder has it so that at least 70% of muscular structures. And muscles hold a lot of emotion, just like, it’s like wearing your heart on your sleeve. You notice that wearing your heart on your muscular fibers is exactly what is happening. And when you have a lot of worries when you have some emotional distress, the shoulder will always have some dysfunction, whereas you can’t move it or it’s stiff, or it’s painful at night or you can’t turn it in to get the hip pocket or get out your wallet or whatever it is. All these things. And it tends to be more natural and posterior in a small percentage. It could be more pectoralis. Well, then you go to consider cardiac things and all that kind of stuff.

Dr Im Quah-Smith [00:39:07] So that’s what somatisation is when it comes to the shoulders. So it tends to be more wary, preoccupation for a long, long, long period of time, and emotional distress. When people get the Sciatica Syndrome. Not true Sciatica, which is very rare to get true Sciatica. It’s this why should be a sciatic syndrome because it’s not really people it’s nothing to do with the sciatic nerve. It’s about the muscles to some boerum, the glutaeal muscles being really tight, really spasm. And this whole area involves a whole different dynamic, a whole different set of electrics. And that’s more about internalizing major frustration, major anger, or wrath. Yeah.

Dr Ron Ehrlich [00:39:51] Taking a step back because we’re all on a journey together through our in our life, through this in this modern world. I wonder what you would say is the biggest challenge for an individual on that journey.

The Biggest Health Challenge

Dr Im Quah-Smith [00:40:04] I pondered about this, especially last year, actually, with COVID. And, you know, are we going to become like Italy and France with 800 people dying a day? So I think the most important thing is to do what it takes to get yourself more resilient. And certainly, when I do regular medicine, I’m constantly improving people’s resilience because I’m working in the brain department. But what you can do is meditation.

Dr Im Quah-Smith [00:40:33] Meditation is a wonderful tool. It doesn’t have to be sitting there for an hour lotus position on the floor or something like that. All it needs is 10-15 minutes a day of meditation because meditation immediately goes to your midbrain and then it activates every single corner of the brain to tidy up. And then it all those wonderful positive changes that go down your spinal cord, down your autonomic nervous system chain to the rest of the body. And it’s a wonderful way.

Every day when you meditate, you are really regulating your autonomic nervous system, taking with the stress, restoring function, doing that little bit of housekeeping so you don’t ever go too far left field or too far right field. And then you have a shock or a must nasty infection and then you find you can’t recover or it takes you way longer to recover. So I think working on meditation, a good diet is really important. And I think the one other thing I think it’s important that people are starting to realize is significant is getting good quality sleep.

That isn’t stressed enough. I think in this modern world and with the plethora of devices and watching Netflix or one or two o’clock with the binge movies or whatever, it is, serious people are losing their sleep patterns.

They’re going to get into good sleep habits, get good sleep patterns, because physiologically when your sleep at night is when your body repairs, when the cells are repaired, and when your cells are replaced. And if you’re not sleeping deeply between one and five o’clock in the morning particularly, you’re not going to get any of that repair happening.

Dr Ron Ehrlich: [00:42:12] That’s a wonderful piece of advice. And I want to thank you so much for joining us today and sharing your wisdom today. Thank you so much.

Dr Im Quah-Smith: [00:42:21] Thank you.


Dr Ron Ehrlich [00:42:24] I love that description that Im gives of herself as a human electronic engineer because that is really what we need. We are walking electricity where every nerve in our body works on electrical currents. Every cell, as it moves things in and out of the cell, works on differentials of electrical potential and micro currents.

So her being a human electronic engineer and feeling that the Vascular Autonomic System (VAS), is what she’s feeling for. That energy flow through the body and the resetting, the reregulation of the autonomic nervous system, which is basically what regulates our whole body.

I mean, if you look at our whole nervous system, you know, when I lift my hand up to my head, that’s my peripheral nervous system, relaying a message from my brain down my spine to the muscles which lift my hand up to my head, but so much more of our neurology. I think it’s something like 70 or 80% of our bodies, neurology is the autonomic nervous system, which is just constantly working there in the background and regulating all that goes on. And we talked about heart rate variability.

Dr Ron Ehrlich [00:43:44] I’m reading a book on Polyvagal Theory, which is a wholly novel approach to how we deal with stress hormones, was talking about three cranial nerves there, the tenth cranial nerve, which is the vagus nerve. She was talking about the superior cervical nerve and also the trigeminal nerve, which is the fifth cranial nerve. So these are all very connected to the ear or the auricular area there. And that is what the focus is on — a way of reading dysfunction or dysregulation of the nervous system and a way of restoring it.

And I thought also, Im’s parting comments to us about building resilience is really what this program is all about. It’s about identifying and minimizing the stresses in life that cause autonomic neural dysregulation or chronic inflammation. Or you may hear the word cytokine storm. These are all presentations of similar things.

And on the other hand, building resilience by focussing on the five pillars of health, sleep, breathe, nourish, move and think. And we have a wonderful online program coming in the second half of this year, which I would encourage you to click onto and become part of that community and that program.

Dr Ron Ehrlich [00:45:06] Look, I hope this finds you well. We’ll have links to Dr. Im Quah-Smith’s practice and her resources on her website and so much of her research around Auricular Therapy, Low Energy Laser Therapy, Acupuncture, and Posturology. She’s got so many wonderful resources on her site, which will have all links to. I hope this finds you well until next time. This is Dr Ron Ehrlich. Be well. 

This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern, he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions, experiences, and conclusions.