You see a raspberry. I see how crazy anxious she is about her annual review. Courtesy of

Liver and Heart: Why You Feel Like S*&t.

Show me your tongue, and I’ll show you a story of anger, anxiety, and why you’re not sleeping.

Maybe it’s because I work in New York City, a place where rage is listed under “things to do,” but my patients come to me over and over and over again with two major problems: anger and anxiety. Here’s how we think about them and treat them in Chinese medicine.

I can’t see her tongue, but she looks both anxious and angry so imma call that anxgry. By Lara604 ( [CC BY 2.0 (], via Wikimedia Commons.

Liver vs. Heart
In Chinese medicine, there are two main organs that deal with emotions: the liver and the heart. The liver carries stronger, more dominant emotions. It’s associated with frustration, anger, irritability, and tension. The person who loses it when you bump into them on the subway and screams from Penn Station to Jay Street? They’re probably a liver-dominant person, and you can identify them (aside from the fury and the throwing things) because the sides of their tongue will be bright red. Heart is much softer. People with a surplus of heart are sad, anxious over-thinkers who can’t shut off their brains. For example, if some aggro liver person shouts, You’re fired!” and they feel the tears well up and know they’re on the verge of a full “ugly-cry,” multi-day breakdown that’ll make them question their very existence, they’re probably heart-dominant. I’d expect to see that the tip of their tongue would be super red and inflamed, just like their nerves after annual reviews. Sometimes, people have both heart and liver overload — the one-two punch of anxiety and anger. These people have what I like to think of as a horseshoe tongue, because it’s typically inflamed and red allllllll the way around. Horseshoe tongue points to a semi-crisis situation and means that, psychologically speaking, the crap has hit the fan.

Heart and Liver vs. Sleep
I have a lot of patients who deal with insomnia and sleep issues, and I get it. New York has 1,000 pressures — work and commutes and everyone getting in your face and the basic challenges of being one of eight million people living on the same tiny island. As you probably guessed, a lot of these sleep problems break down to some degree of heart and liver issues. When somebody’s having trouble falling asleep or staying asleep due to anxiety, that’s a heart issue. They’re restless, stuck in their heads, obsessing about details and playing out the same internalized conflicts again and again. Or maybe they’re having stressful dreams that are just an extension of their stressful day-to-day. Maybe liver will sneak in there with irritability and a general sense of HULK SMASH that’ll keep them wide awake.

What Should You Do?
I’m going to sound like a broken record, but it’s really all about finding balance, and that means going to the root of the problem. In acupuncture, the answer for both heart and liver overload starts with slowing the system down, trying to relax it, and getting it to a place of calm and quiet. That means needling lots of emotional points on the ears and head and leaving the needles in to for a longer time — closer to 45 minutes. If herbs are an option, there’s a famous formula that I love for heart called tan wang bu xin dan*. It’s pretty wonderful for anxiety and trouble sleeping, and I find it works extremely well for most patients. But in addition to Chinese medicine, you need to give your system a chance to heal and build it up from a healthy, balanced place. Here are a few ways to start:

When you’re pushed to your limits, it’s important to approach the problem from all sides, especially if you live in a bustling, busy place. Take New York. It’s a bigtime liver town. Everyone here is so aggressive, and let’s face it, people with a lot of heart get pushed around. That’s why self-care is so important when it comes to anxiety and anger. You need to give yourself an opportunity to step away from work, life, and the craziness of the world, and build up and strengthen your own center. And with a little effort, that time away will give you a way to decompress, find some steady ground, and actually get some sleep.

*As always, never take herbs before consulting with a licensed acupuncturist/herbalist.