APPENDIX III: CRACKDOWN ON FALUN GONG
Document 12: Psychophysiological Reactions Associated with Qigong Therapy
Shanghai Mental Health Center, Psychiatric Department, Shanghai Medical University358
Qigong as a part of the traditional Chinese medicine is similar to Western "meditation," Indian "Yoga" or Japanese "Zen," which can all be included in the category of traditional psychotherapy. A series of physiological and psychological effects occur in the course of Qigong training, but inappropriate training can lead to physical and mental disturbances. Physiological effects include changes in EEM, EMG, respiratory movement, heart rate, skin potential, skin temperature and fingertip volume, sympathetic nerve function, function in stomach and intestine, metabolism, endocrine and immunity systems. Psychological effects are motor phenomena and perceptual changes: patients experience warmness, chilliness, itching sensation in the skin, numbness, soreness, bloatedness, relaxation, tenseness, floating, dropping, enlargement or constriction of the body image, a sensation of rising to the sky, falling off, standing upside down, playing on the swing following respiration, circulation of the intrinsic Qi, electric shock, formication,359 during Qigong exercise. Some patients experienced dreamland hallucinations, unreality and pseudohallucination. These phenomena were transient and vanished as the exercise terminated. Qigong deviation syndrome has become a diagnostic term and is now used widely in China.
Qigong is a traditional Chinese modality for promoting health and curing diseases. Qigong as part of traditional Chinese medicine is similar to western "meditation," Indian "Yoga" or Japanese "Zen," which can all be included in the category of traditional psychotherapy.
A series of physiological and psychological effects occur in the course of Qigong training, which is somewhat similar in nature to biofeedback and some behavioral treatment in modern medicine. Inappropriate training can lead to physical and mental disturbances. More and more importance has been attached to the role of Qigong therapy in psychosomatic medicine. This article, from the viewpoints of medicine and psychology, deals with the role of Qigong therapy in physical and mental health problems.
Traditional Chinese medicine believes that Qigong is a self-training through "spirit" (jing), "vital energy" (qi) and "mind" (shen) of the human body, which balances Yin and Yang (negative and positive), circulating the vital energy and the blood, coordinates internal organs, clears and activates the main and collateral channels, so as to adjust physical and mental state.
The research in modern science proves that Qigong training has extensive effects and influences on various systems of the human body. It includes the changes in EEC, electromyogram EMG, respiratory movement as well as the declining of such physiological indices as heart rate, skin potential, skin temperature and fingertip volume, which reflects the changes of physiological functions, functional changes of autonomic, especially sympathetic nerve systems. During Qigong training, there exhibit a lot of physiological effects such as improvement of stomach and intestine function and the changes in metabolism, endocrine and immunity functioning. 
These effects represent an integration of multidimensional functions of the physiological systems in a special state of consciousness induced by Qigong. The integrated effects appear to have close correlation and synchronism with the activities of human body systems. Qigong functional state produced by relaxation and meditation in a special state of consciousness provides favorable conditions to regulate the physiological functioning either in a single system or between various systems, so as to achieve proper synchronism and good equilibrium. Body oxygen consumption decreases in this Qigong state, which implies relaxation and meditation may help adjust the energy metabolism and decrease the energy expenditure, which is favorable to energy accumulation. 
The state of "Rujing" (entering into the state of total calmness) in Qigong obtained through relaxation and meditation is a peculiar mental state. Through self-adjustment, the trainee finds himself in a functional state different from sleeping, waking or dreaming. During this time, the internal functions are supposed to be highly coordinated and in good order, which may exert some changes on mental activities with the effect of dampening psychological stress.
The author reported the clinical phenomena during Qigong exercise, i.e., 1) motor phenomena: jerking, twitching, tremulous and spontaneous movement; 2) perceptual changes: patients experiences warmness, chilliness, skin-itching, numbness, bloatedness, relaxation, tenseness, floating, dropping, enlargement or constriction of the body image, changing of the body image along with respiration, disappearance of body image, a sensation of rising to the sky, falling off, standing upside down, playing on the swing following respiration, loss of cognition of space-time continuum, circulation of the intrinsic Qi, electric shock sensation and formication during Qigong exercise. Some patients also had dreamland experience, feeling of unreality and some motor-sensory disturbances. Moreover, a variety of pseudohallucination may occur.  However, all these phenomena were transient and vanished as the exercise terminated.
Qigong healing modality can be regarded as a typical psychophysical therapy, and people will naturally consider applying it to the treatment of psychosomatic diseases. There have been many reports in this aspect, including the treatment of hypertension, asthma, coronary heart disease, gastric and duodenal ulcer, and allergic colitis. Besides, therapeutic effects on insomnia, depression, anxiety, neurosis, and childhood attention deficit syndrome have been reported.
Incorrect performance of Qigong exercise can lead to some somatic or psychological disturbances, just like what appeared during the early phase of over-meditation reported by Otis in 1973.  Such syndrome manifested during or after the Qigong exercise may be called "Qigong deviation," which has become a diagnostic term now widely used in China. It has also been included in the Chinese Classification of Mental Disorders (1989.) 
The mental disturbances initiated by Qigong exercise has aroused wide interests and discussion now among Chinese psychiatrists and Qigong researchers.
The diagnosis of "Qigong deviation syndrome" showed the following criteria: 1) normal behavior before doing Qigong exercise; 2) psychological and physiological reactions appear during or after Qigong exercise; suggestion and autosuggestion may play an important role; 3) the manifestation of Qigong deviation syndrome does not meet the diagnostic criteria of schizophrenia, affective disorder and neuroses.
The clinically common symptom of Qigong deviation is the uncontrolled flow of "Qi" (energy) in the body. All of the cases has such complaints as "Qi moving and dashing within the body" or "Qi dashing and rushing into the head," often stagnating somewhere and leading to pain, with some strange perception in the lower abdominal area called "Dan Tian" (elixir field.) The incessant movement of the vital energy may give rise to an unusual malaise as well as various physical symptoms such as headache, insomnia, discomfort, abdominal distension and others. Owing to the exercisers' overemphasis upon the experience of "arrival of Qi," many interesting psychic phenomena may be derived from: Qi being "stolen" - for instance, an elderly woman was furious when the instructor removed her Qi to another exerciser. She gave that exerciser a box on the ear and asked him to return her Qi. "Induction" of Qi - once there were two exercisers (patients with chronic physical illness) who were in the same ward. One day, one of them gave a puff inadvertently to the other, the latter soon began to dance elegantly. After a little while he told the other mysteriously: "Oh, this is caused by the communication between my Qi and yours." The psychic problem may arise on account of the attitude of the exerciser to the Zi Fa Gong (spontaneous skill), which manifests itself as fast, strenuous and irregular movement with large motions. Some schools of Qigong (as in the crane-flying Qigong) emphasize that the earlier, the larger and the faster the spontaneous skill emerges, the better results will ensue, therefore the exercisers spare no efforts to seek for the spontaneous skill.  In most of the exercisers, sensation of Qi, as well as the spontaneous skill were caused by suggestion and autosuggestion and they are prone to develop psychic disorders.
The common symptoms in mental disturbance are anxiety, nervousness, depression, etc. Seriously ill patients cannot control their own behavior. Some patients are found to have hallucination or delusion, and some even have the impulse of committing suicide.
Qigong deviation syndrome is a mental disorder closely related to the cultural background, and also to superstition or witchcraft (Case 2.)
The mental and physical disturbances caused by Qigong deviation have the characteristics different from other psychotic disorders. Their causes are rather complicated. The author has done some tentative study on their clinical and causative factors.
Of the patients, 25 psychotic cases were assessed by Brief Psychiatric Rating Scale (total mean score of BPRS: 44.89 ± 9.42), and 50 neurotic cases were assessed by Hamilton Rating Scale (total mean score of HAMA [Hamilton depression]: 16.82 ± 6.90; total mean score of HAMD [Hamilton rating scale for depression]: 16.00 ± 8.30.) There are significant differences between the Qigong deviation group and the control group (mean score of HAMD: 2.58 ± 2.22, t = 11.04, P<0.001; mean score of HAMA: 1.94 ± 1.66, t = 11.83, P<0.001.)
Case 1: Mr. A is a 22-year-old unmarried worker. He began to learn himself from Qigong books the "Wu Qin Xi" (exercise mimicking the gestures of five animals) on November 26, 1984 for the treatment of lumbago. Ten days later, he suddenly had "special cenesthesiopathy" with "Qi" flowing adversely in the head and abdomen. When "Qi" flowed into his head, he felt fullness of head and chest distress. When showing a Qigong gesture, he suffered agony and anxiety, even attempting to commit suicide. Two hours later he was sent to Shanghai Institute of Qigong for help. Guided by a Qigong master he recovered. The next day he became delirious and claimed that he could hear the voice of evil spirits; he prayed to Buddha for help but only lost his self control. During the intervals of the attacks, the patient was normal. But he could not work normally due to insomnia and difficulty in coping with Qigong deviation.
On January 15, 1985, the patient got upset because he was prevented by his family from doing Qigong exercise. He felt so hopeless that he attempted to commit suicide by bumping his head into a car. He was then sent to a hospital for psychiatric treatment. There were no abnormal findings in his physical and laboratory check-up. There was no history of psychosis in his family either. He was treated timely by ECT. Two days later, his father took him back home. Now he is followed up by a Qigong master and is so far in good health state.
Case 2: Mr. B is a 44-year-old married painter. He learned on his own the "He Xiang Zhuang" (crane-flying Qigong), another school of Qigong in February 1984, attempting to treat his ailment, the hypertrophy of cervical vertebra. He had no personal psychiatric history, neither his family. Several days after Qigong exercise, he was suddenly agitated with hyperthymia. He claimed that he knew everything in the world, "water is associated with the sea," when he talked about the sea, he would "think of the American continent."
Three days later, he was diagnosed as schizophrenia-like disorder and was treated in Shanghai Psychiatric Hospital. One month later he had remission.
Later he turned to learn the "Long Men Five Flow," another school of Qigong. On the third morning he suddenly began to cry and dance, still doing Qigong exercise in bed. He thought that his dead mother would be brought back to life whereas he would become a ghost. He said that he could see Buddha and God, and he believed in religion. He also smelt something unusual. He was again admitted to Shanghai Psychiatric Hospital.
Mental examination: the patient has emotional instability, with no delusion and hallucination, sometimes posing in a Qigong gesture and has intermittent attacks. EPG: extroversion. MMPI: schizophrenic character. He was given 100 mg CPZ im, bid. A week later, he recovered from his illness and now works as before.
Attention should be paid to the prevention and treatment of various mental and physical disturbances due to Qigong deviation.
1. Lin YG. Progress of combined traditional Chinese and Western medicine in the field of Qigong. Chin J Integ Trad West Med 1988; 8:82.
2. Lin YG. Study on the physiological effects of meditation in Qigong. International Conference on Trad Chin Med & Pharm Proceedings. China Academic Publishers 1987; 1014.
3. Xu SH. Analysis of the clinical phenomena of Qigong therapy in 100 cases. J Trad Chin Med 1961; 5:34.
4. Michael West. Meditation. Brit J Psychiat 1979; 135: 457.
5. China Neuro & Psychiat Association. Chinese classification and diagnostic criteria of mental disorders (CCMD-2). Beijing: CNPA, 1989: 66.
6. Zhai ST, Zhang XB. Psychological problems in Crane-Flying Qigong. The Asian Pacific Regional Symposium on Psychosocial & Cultural Aspects WPA/Nanjing China, 1985: 387.
Document 13: A First Look at the Forensic Psychiatric Evaluation of Falun Gong Cases
Shen Jun and Gong Yantao360
In this article, we explore various issues regarding the forensic psychiatric assessment of [criminal] cases involving the Falun Gong.
Female, 45 years old, a worker, educated to lower middle-school level. She first started practicing Falun Gong in 1996 because she had chronic colitis and hyperplasia of the lumbar vertebrae. She gradually became obsessed with Falun Gong, practicing it all day long, rarely eating, unwilling to see a doctor or take medicine when she fell ill, growing ever more estranged from her family, her health declining markedly, and yet she flagrantly told everyone how much she was benefiting from her practice of Falun Gong. Even after the government declared Falun Gong to be an evil cult, she refused to be dissuaded from her beliefs and continued gathering people to practice Falun Gong. Moreover, she went to Beijing to petition the authorities361 [about the suppression of the group] and was then placed under criminal detention, but still she persisted in practicing Falun Gong; and she stopped sleeping.
Psychiatric examination: Consciousness clear and alert; markedly excited and loquacious; declared that since taking up Falun Gong she had been able to overcome all the tests and tribulations of life, though not yet to the point of having opened up her "heaven's eye";362 regarded herself as currently being in excellent health and said that she felt very energetic even after not eating for several days; and insisted that her original ailments had been cured without taking any medicine. Furthermore, she said that she could see three suns in the sky and also a five-colored auspicious cloud, and that the "Master" [i.e. Li Hongzhi] was protecting her at all times. Sometimes when no one was present, she could hear someone telling her to "go to Beijing, and once you have overcome the three trials then your merit will be complete,"363 and saying, "if you're going, then go quickly." She said that her bloodstream was filled with constantly revolving tiny gems made up of high-energy cosmic matter, and that this caused her skin to shine with a special glow. Her emotional responses were also inappropriate.
Forensic finding: mental disorder caused by practicing an evil cult; no capacity to bear legal responsibility; recommend medical treatment.
Male, 62 years old, educated to upper middle-school level, a department manager in an electrical equipment factory. After suffering from insomnia for a long time, in 1995 he took up practicing various kinds of qigong, and in 1997 he became besotted with the practice of Falun Gong. He soon became solitary and untalkative, and he began giving people valuable presents for no reason. He always ate less than other people and would buy the cheapest of foods, to the point even of buying and taking home items that other people had turned down. He said that [this was because] he wanted to be a genuinely "truthful, compassionate and forbearing"364 person. After the government declared Falun Gong to be an evil cult, she not only ignored all efforts to dissuade him from continuing to practice Falun Gong, but also joined with other practitioners in traveling to Beijing to "uphold the dharma"365 on behalf of Falun Gong.
Psychiatric examination: Consciousness clear and alert; declared that since practicing Falun Gong all his previous illnesses had been cured, and that if allowed to practice for just one more month his white hair would all turn black once again, his skin would become softer and clearer, and he would become "thoroughly rejuvenated."
Diagnosis: mental disorder caused by practicing an evil cult; should bear partial legal responsibility for his crimes.
Male, 3 years old, a worker. In 1992 he began to show signs of mental abnormality, with frequent recurrence of symptoms. In 1997, after his family heard that one could cure illnesses by practicing qigong, they told him to take up Falun Gong. Moreover, he then frequently participated in, and gathered others to take part in, trips to Beijing to petition [against the suppression of the group], thereby exerting an extremely bad influence in society.
Psychiatric examination: Consciousness clear and alert; constantly over-excited; declared that since taking up Falun Gong he had gained even greater superhuman abilities than before; that he could summon the winds and rain at will; that he could tell what was going on in people's minds without the use of any instruments of detection; and that his soul had been fully realized and he was able to maintain frequent contact with aliens from outer space. He said that his purpose in going to Beijing was to use his qigong-acquired merit to make Tiananmen Square become a better and smaller place. His thinking was extremely chaotic.
Diagnosis: schizophrenia; behavior and actions completely dominated by pathological factors, and hence no capacity to bear legal responsibility.
Female, 41 years old, a cadre, college educated. She began practicing Falun Gong in 1996 and gradually became a die-hard element within her collective practice group. After the government ordered the banning of Falun Gong, and rejecting all efforts to persuade and educate her away from the cult, she continued to organize groups of practitioners to carry out petitioning activities on its behalf.
Psychiatric examination: Consciousness clear and alert; thinking logical and well-ordered; she defended with extreme vigor the various advantages of practicing Falun Gong, and in so doing slandered and vilified [China's] present social realities; apart from being emotionally over-excited, she showed no signs of hallucination, delusions or other conspicuous mental abnormalities.
Forensic finding: not mentally ill; should be held legally responsible for her crimes.
Falun Gong is entirely different from ordinary kinds of body cultivation techniques, and no clear definition of the type of mental disorders that it produces can be found within China's currently used body of diagnostic criteria for mental illness. This creates distinct difficulties for us in the conduct of forensic psychiatric assessments work. Since the number of Falun Gong practitioners is relatively great, their scope and distribution is relatively broad and hence they exert a rather strong sociopolitical influence, it is essential that we strictly adhere both to psychiatric-medical criteria and also to legal-scientific criteria when carrying out forensic psychiatric assessments work in this area. This means carefully distinguishing between the following subjects of forensic appraisal: ordinary practitioners who were tricked and deceived into taking up Falun Gong; people who were previously suffering from mental illness and then began practicing Falun Gong as a consequence of their psychiatric symptoms; people who were not previously mentally ill but have since developed mental abnormalities as a result of their obsession with Falun Gong; and the die-hard Falun Gong elements who are mentally quite normal and who have obstinately persisted in their erroneous beliefs and actions.
As can be seen from the forensic case examples given above, mental disorders caused by evil cults usually have the following characteristics:
1) Prior to commencing Falun Gong practice, in most affected cases certain socio-psychological factors were already in evidence (including varying degrees of personality defect, certain physical ailments or various unhappy life experiences), but there was no clear history of mental illness of any kind.
2) In most cases, those affected had been practicing Falun Gong for one year or more, they had become severely infatuated with it, and no amount of repeated education or persuasion, in whatever form, had succeeded in bringing them to their senses.
3) In most cases, the mental abnormalities emerged slowly and then gradually worsened (although there were also cases in which the symptoms arose suddenly and very conspicuously); and by contrast with the kinds of temporary, minor and partial changes in mental activity that can arise in the cases of those entering special qigong states,366 these mental abnormalities were protracted in duration.
4) There were certain similarities between the manifestations of these mental disorders and the kinds of mental disorders that can be induced by popular body cultivation techniques, for example, disturbances of sensory perception and of behavior. But there were also differences, namely that in the case of Falun Gong-induced mental disorder both delusions and impairments of logical reasoning could also be found, often mixed in together with elements of objective reality or proximate reality, and moreover these were all closely interconnected with the evil cultic influence of Falun Gong's doctrine of "Truthfulness, Compassion and Forbearance." 
5) The social functioning of those affected was more severely damaged, and their response to specialist medical treatment was much poorer, as compared to those suffering from mental disorders caused by popular body cultivation techniques.
6) The original objective of those starting Falun Gong practice is usually self-improvement - for example, curing illnesses, physical cultivation or escaping from psychological difficulties - and in most cases their behavior is not premeditated or driven by any deep-seated social motive.
If we exercise comprehensive judgment [based on the above points], it is usually not difficult to make a diagnosis of evil cult-induced mental disorder.367 At the same time, [these criteria] will help us to identify, and to maintain our guard against, any die-hard Falun Gong elements who might try to feign mental illness as a way of escaping legal punishment for their activities.
On the question of how to ascertain the capacity for legal responsibility in Falun Gong cases: although there are as yet no clear, government-stipulated legal criteria for forensic evaluations in this area, we nonetheless feel that the same principles should be applied as in other types of criminal cases. That is to say, we should first of all determine whether or not the person being appraised is mentally ill, and if so, the degree of severity of their illness, and then establish whether their behavior was prompted by pathological factors or by authentic criminal motives.  This requires that we comprehensively investigate the situation, make an overall objective analysis, and provide a thorough scientific verification of our findings. 
· In cases where the examinee has become so obsessed with Falun Gong that their entire mental activity has fallen under evil cultic control and they have lost the capacity to ascertain reality and control themselves, a finding of no capacity to bear legal responsibility for their crimes should be made.
· On the other hand, in cases where only temporary or minor mental disorders arise following the practice of Falun Gong, and where those concerned have retained or only partially lost their capacity to ascertain reality and control themselves, a finding of either ability or partial capacity to bear legal responsibility should be made.
· And in cases where mental abnormality is not pronounced, and where the examinees' activities have been primarily directed against society and they have been able, moreover, to painstakingly plot and organize illegal activities, a finding of full legal responsibility should be made, as a means both of striking out hard against evil cults and of safeguarding the effective implementation of our national laws.
In view of the fact that Falun Gong practitioners constitute a special social group, but there has so far been an insufficiency of case material, and not enough investigation done, either to clarify the diagnostic criteria that should be used in the forensic psychiatric evaluation of Falun Gong cases or to indicate what the correct determination of legal responsibility should be, we furthermore propose that the relevant experts in this field should set up a special task force to study these various issues and to provide guidance for the future development of this work.
1. Wu Caiyun, "A Clinical Analysis of 76 Cases of Qigong-induced Mental Disorder Characterized Mainly by Hallucination and Delusion," Journal of Clinical Psychological Medicine (Linchuang Jingshen Yixue Zazhi), 1991, 2:7.
2. Xu [characters unclear], "A Discussion of Several Questions Relating to the Forensic Assessment of Mental Disease," Shanghai Archives of Psychiatry (Shanghai Jingshen Yixue), 1999, (New) 11:9.
3. Zheng Zhanpei, "On the Evaluation of Degree of Mental Injury, and Some Issues for Attention in Practical Work," Chinese Journal of Psychiatry (Zhonghua Jingshenke Zazhi), 2000, 1:6.
358 Chinese Medical Journal (Beijing), vol. 107, no. 3 (1994), pp.230-233. The journal is published in English and the present text is as it appears in the journal; no attempt has been made here to correct the English grammar.
359 A crawling sensation on the skin, as if covered with ants.
360 Journal of Clinical Psychological Medicine (Linchuang Jingshen Yixue Zazhi), vol. 10, no. 5 (2000), pp.313-314.
362 "tian mu": in Falun Gong philosophy, a point located in the center of the forehead and equivalent to the "third eye" of other popular religions or sectarian belief systems.
363 "guole san-guan jiu gongde yuanmanle."
364 See Note 15, above.
365 "hu fa": also translatable as "defend the teachings."
366 The authors are probably referring here to "qigong-induced mental disorder" (also known as "qigong deviation"), a psychiatric diagnosis that was formally included in the Chinese Classification of Mental Disorders (CCMD-II) in 1989; for a detailed discussion of this Chinese-style "culture-bound disorder," see Document 12, above.
367 "xie jiao suo zhi de jingshen zhang'ai."