Cupping Therapy vs. Bruising

Understanding Practice, Physiology, and Misconceptions

In today’s wellness landscape, cupping therapy has re-emerged as a widely used modality for relieving pain, improving circulation, and supporting holistic healing. Despite its growing popularity, many people unfamiliar with Traditional Chinese Medicine (TCM) often confuse the distinct circular marks left by cupping with bruises from injury. Though they appear similar, the mechanisms, meanings, and physiological effects are fundamentally different. This article provides a thorough understanding of cupping therapy, its roots in TCM, its interpretation through the lens of Western science, and how it compares to traumatic bruising, to clarify misconceptions and deepen appreciation for this ancient practice.

What Is Cupping Therapy?

Cupping is a technique that involves placing specially designed cups (glass, silicone, bamboo, or plastic) onto the skin to create suction. The suction pulls the skin and superficial tissue upward, promoting blood flow, stimulating lymphatic drainage, and mobilizing stagnation.

In Traditional Chinese Medicine (TCM), cupping is used to:

– Move stagnant qi and blood

– Expel pathogenic factors (wind, cold, damp)

– Open the meridians and facilitate energy flow

– Relieve pain, tightness, and toxicity

– Strengthen organ function by targeting specific meridian points

The Western Physiological View: How Cupping Works

Western medicine traditionally lacked a framework for cupping, but increasing interest has revealed several plausible mechanisms:

Increased Local Blood Flow – Suction draws blood to the surface, improving microcirculation (Lowe, 2017).

2. Fascial Decompression – Cupping lifts and separates skin, fascia, and underlying muscles, similar to myofascial release.

3. Neurovascular and Pain Modulation – Stimulation triggers responses through the Gate Control Theory of Pain (Teut et al., 2018).

4. Controlled Inflammatory Response – Mild trauma initiates a low-grade inflammatory response (Furhad et al., 2023)

5. Lymphatic Drainage – The pressure differential helps clear toxins and reduce swelling.

6. Parasympathetic Nervous System Activation – Can reduce stress and activate rest-and-digest mode (Harvard Health Publishing, 2016).

Types of Cupping

– Dry Cupping: Standard suction without bloodletting

– Wet Cupping (Hijama): Involves superficial pricking after suction

– Fire Cupping: Traditional method using heat to create vacuum inside the cup

– Gliding (Massage) Cupping: Cups are moved across oiled skin for deep tissue stimulation

Understanding Bruising from Injury

A bruise (contusion) results from accidental trauma to soft tissue, leading to rupture of capillaries and pooling of blood under the skin. This causes pain, swelling, discoloration, and inflammation. Unlike the controlled effect of cupping, bruising often involves deeper tissue damage.

Comparison: Cupping Marks vs. Bruises

Cupping Marks vs. Bruises:

– Cause: Suction-induced capillary rupture vs. blunt trauma

– Intentional: Yes vs. No

– Purpose: Healing vs. Accidental

– Appearance: Uniform circles vs. irregular, color-changing marks

– Pain: Minimal vs. often painful

– Duration: 3–10 days vs. 1–3 weeks

Final Thoughts: Healing vs. Harm

Cupping is not a bruise in the conventional sense. It’s a controlled, purposeful therapy used to stimulate the body’s self-healing mechanisms. While cupping marks may resemble bruises visually, their nature, origin, and physiological impact are completely different. Understanding these differences demystifies this ancient therapy and makes it more approachable for those seeking holistic healing.

⚖️ Side-by-Side Comparison: Cupping Marks vs. Bruises

Aspect	Cupping Marks	Bruises (Injury)
Cause	Suction-induced capillary rupture	Blunt trauma to tissues
Intentional?	Yes – therapeutic	No – accidental
Purpose	Detox, release stagnation, promote healing	None – consequence of trauma
Appearance	Uniform, circular, reddish-purple	Irregular, color changes over time
Pain Level	Minimal to none	Tender or painful, often with swelling
Color Pattern	Dark → fade gradually	Red → purple → green → yellow
Duration	3–10 days	1–3 weeks, depending on severity
Associated Symptoms	Relief, improved mobility, relaxation	Inflammation, soreness, potential joint restriction

References:

Furhad, S., Sina, R. E., & Bokhari, A. A. (2023, October 30). Cupping therapy. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK538253/

Harvard Health Publishing. (2016). What exactly is cupping? Harvard Health Blog. https://www.health.harvard.edu/blog/what-exactly-is-cupping-2016093010402

Johannes, L. (2012, November 12). Centuries-Old art of cupping may bring some pain relief. WSJ. https://www.wsj.com/articles/SB10001424127887324073504578114970824081566

Lowe, D. T. (2017). Cupping therapy: An analysis of the effects of suction on skin and the possible influence on human health. Complementary Therapies in Clinical Practice, 29, 162–168. https://doi.org/10.1016/j.ctcp.2017.09.008

Teut, M., Ullmann, A., Ortiz, M., Rotter, G., Binting, S., Cree, M., Lotz, F., Roll, S., & Brinkhaus, B. (2018). Pulsatile dry cupping in chronic low back pain – a randomized three-armed controlled clinical trial. BMC Complementary and Alternative Medicine, 18(1). https://doi.org/10.1186/s12906-018-2187-8

Limbic System and the Emotional Dimension of Pain

Pain is not solely a sensory experience. It is also deeply emotional, influenced by context, memory, expectation, and mood. While the somatosensory cortex processes the discriminative (sensory) aspects of pain, such as location, intensity, and duration, the limbic system, particularly the amygdala and the anterior cingulate cortex (ACC), mediates its affective (emotional) and motivational components (Apkarian et al., 2005; Leknes & Tracey, 2008).

1. The Amygdala: Fear, Salience, and Emotional Memory

The amygdala is a central structure in emotional processing, especially in the encoding and recall of fear and threat-related memories. It plays a critical role in the emotional coloring of pain and how we anticipate and respond to it.

The amygdala receives nociceptive input via the spino-parabrachial pathway and from higher-order cortical areas, allowing it to influence both immediate emotional reactions to pain and pain-related memory (Neugebauer et al., 2004).
It activates autonomic and behavioral responses to pain (e.g., anxiety, avoidance), especially when pain is perceived as threatening or unpredictable.
Amygdala hyperactivity has been linked with chronic pain conditions, where emotional reactivity and threat perception become amplified (Simons et al., 2014).

In other words, the amygdala adds emotional salience to nociceptive stimuli, transforming a mere sensory signal into a subjectively distressing experience.

2. The Anterior Cingulate Cortex (ACC): The Distress and Motivation Circuit

The ACC, particularly its rostral and dorsal regions, plays a central role in pain unpleasantness, emotional suffering, and motivational drive to escape or alleviate pain.

Studies show that ACC activation correlates with subjective pain unpleasantness, even when the physical intensity of pain is constant (Rainville et al., 1997).
The ACC is richly interconnected with limbic (amygdala, hippocampus), cognitive (prefrontal cortex), and motor systems, enabling it to integrate affective, attentional, and behavioral responses to pain (Shackman et al., 2011).
The ACC is involved in pain anticipation, which can amplify emotional distress even before the pain occurs (Koyama et al., 2005).
Chronic pain patients often show structural and functional changes in the ACC, suggesting a maladaptive feedback loop that reinforces pain-related suffering (Baliki et al., 2006).

Thus, the ACC is not responsible for detecting pain, but for how unpleasant and distressing it feels, and for driving the motivational state to take action.

3. Limbic Modulation and Homeostasis

Leknes & Tracey (2008) propose a framework for understanding how pain and pleasure share overlapping neurobiological systems, particularly in limbic circuits. They note that context, expectation, and emotional state can either amplify or dampen pain via top-down modulation of limbic and brainstem structures.

The ACC and amygdala are sensitive to emotional reappraisal, social support, and placebo analgesia, demonstrating that the emotional meaning of pain can drastically change the experience (Wager et al., 2004).
Pain that is interpreted as meaningful or self-chosen (e.g., in rituals or athletic endurance) can be experienced as less unpleasant, implicating limbic regulation of pain perception (Leknes & Tracey, 2008).

This suggests that the limbic system is central in determining whether pain is perceived as threatening and intolerable or manageable and meaningful.

4. Summary of Functional Roles

Region	Role in Pain Processing
Amygdala	Assigns emotional salience; fear, anxiety, memory of pain; enhances pain when perceived as threatening.
ACC	Encodes pain unpleasantness; mediates suffering, motivation to escape pain; modulated by expectation, attention, and emotional context.

Clinical Relevance

Chronic pain syndromes (e.g., fibromyalgia, neuropathic pain) often involve heightened activity in the amygdala and ACC, contributing to emotional suffering, catastrophizing, and avoidance behavior (Hashmi et al., 2013).
Cognitive-behavioral therapy (CBT), mindfulness, and biofeedback target these limbic circuits to reframe pain perception, reduce suffering, and restore functional coping.
The limbic-emotional dimension of pain underscores the importance of holistic and biopsychosocial models in treatment.

References:

Apkarian, A. V., Bushnell, M. C., Treede, R. D., & Zubieta, J. K. (2005). Human brain mechanisms of pain perception and regulation in health and disease. European Journal of Pain, 9(4), 463–484. https://doi.org/10.1016/j.ejpain.2004.11.001

Baliki, M. N., Geha, P. Y., Apkarian, A. V., & Chialvo, D. R. (2006). Beyond feeling: chronic pain hurts the brain, disrupting the default-mode network dynamics. Journal of Neuroscience, 28(6), 1398–1403. https://doi.org/10.1523/JNEUROSCI.4123-07.2008

Cleveland Clinic. (2024). Limbic system: What it is, function, parts & location [Illustration]. Cleveland Clinic. https://my.clevelandclinic.org/health/body/limbic-system

Hashmi, J. A., Baliki, M. N., Huang, L., Baria, A. T., Torbey, S., Hermann, K. M., … & Apkarian, A. V. (2013). Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain, 136(9), 2751–2768. https://doi.org/10.1093/brain/awt211

Koyama, T., McHaffie, J. G., Laurienti, P. J., & Coghill, R. C. (2005). The subjective experience of pain: Where expectations become reality. Proceedings of the National Academy of Sciences of the United States of America, 102(36), 12950–12955. https://doi.org/10.1073/pnas.0408576102

Leknes, S., & Tracey, I. (2008). A common neurobiology for pain and pleasure. Nature Reviews Neuroscience, 9(4), 314–320. https://doi.org/10.1038/nrn2333

Neugebauer, V., Galhardo, V., Maione, S., & Mackey, S. C. (2009). Forebrain pain mechanisms. Brain Research Reviews, 60(1), 226–242. https://doi.org/10.1016/j.brainresrev.2008.12.014

Rainville, P., Duncan, G. H., Price, D. D., Carrier, B., & Bushnell, M. C. (1997). Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science, 277(5328), 968–971. https://doi.org/10.1126/science.277.5328.968

Shackman, A. J., Salomons, T. V., Slagter, H. A., Fox, A. S., Winter, J. J., & Davidson, R. J. (2011). The integration of negative affect, pain and cognitive control in the cingulate cortex. Nature Reviews Neuroscience, 12(3), 154–167. https://doi.org/10.1038/nrn2994

Simons, L. E., Elman, I., & Borsook, D. (2014). Psychological processing in chronic pain: a neural systems approach. Neuroscience & Biobehavioral Reviews, 39, 61–78. https://doi.org/10.1016/j.neubiorev.2013.12.006

Wager, T. D., Rilling, J. K., Smith, E. E., Sokolik, A., Casey, K. L., Davidson, R. J., … & Cohen, J. D. (2004). Placebo-induced changes in FMRI in the anticipation and experience of pain. Science, 303(5661), 1162–1167. https://doi.org/10.1126/science.1093065

Post-traumatic Growth: Essays to Cultivate Healing, Integration, and Meaning

Trauma rarely arrives by invitation. For most people, it enters life unexpectedly, through loss, betrayal, illness, accidents, violence, neglect, coercion, or prolonged stress. Very few individuals seek out traumatic experiences, and just as rarely do most people consciously intend to harm or traumatize others. And yet, despite intent, all actions carry consequences. Words spoken in anger, choices made in fear, systems built on imbalance, and moments of inattention can send ripple effects outward for years, sometimes for generations. Trauma often lives in these ripples.

Long after the original event has passed, many people continue to feel unsettled inside, anxious, guarded, emotionally numb, reactive, ashamed, or unsure of who they have become. These experiences are not signs of weakness or personal failure. They are the natural imprint of overwhelming stress on the nervous system, identity, and relational trust. Trauma changes how the body responds to threat, how the mind interprets reality, how the self is organized, and how relationships are navigated.

My book Post-traumatic Growth – Essays to Cultivate Healing, Integration, and Meaning was written for those who have survived difficult experiences and now find themselves asking deeper questions, not only how to cope, but how to truly grow beyond survival. The gradual cultivation of healing and growth does not mean that trauma was good, necessary, deserved, or spiritually justified. It does not minimize suffering or attempt to frame pain as a gift. Rather, it acknowledges a well-documented truth: human beings possess a powerful capacity to adapt, integrate, mature, and rebuild their lives when safety, awareness, and agency are gradually restored.

For decades, my work has focused on the relationship between stress physiology, emotional regulation, behavior, identity, and resilience. Again and again, I have seen that trauma recovery is not only psychological. It is neurological. It is relational. It is embodied. Insight alone is not enough. Healing requires the reorganization of the nervous system, the development of emotional maturity, the rebuilding of boundaries, the restoration of agency, and the reconstruction of meaning.

This book follows the full arc of transformation. It begins with how trauma disrupts regulation, perception, and identity. It then moves into the practical foundations of recovery by using breath, posture, emotional regulation, and stress resilience. From there, it addresses the deeper psychological work of boundaries, meaning-making, emotional maturity, and agency. Finally, it turns outward toward contribution, service, and the lifelong process of integration and wholeness.

If you are reading this, it is likely because some part of your life has been shaped by adversity, sudden or prolonged, visible or hidden. This book does not offer shortcuts. It offers something more enduring: a grounded path toward rebuilding stability, identity, agency, and meaning over time. These essays are not meant to be rushed or consumed linearly, but revisited as one’s capacity for regulation, reflection, and integration deepens. Growth does not erase the past. It allows you to live no longer defined by it.

Somatic Calibration, Iterative Self-cultivation, and Transmutation

Somatic Calibration

Somatic calibration is the foundational process of aligning body awareness with inner regulation. It involves refining the nervous system’s perception of tension, balance, and breath so the individual can consciously adjust posture, movement, and energetic flow. Through repeated sensory feedback, such as the proprioceptive and interoceptive signals used in qigong, tai chi, or dao yin, the practitioner learns to listen to the body and respond with precision. This phase trains one’s sensitivity and coherence: the capacity to detect micro-imbalances before they manifest as dysfunction.

In neurophysiological terms, this process strengthens the communication between the insula, anterior cingulate cortex, and prefrontal regions, the areas responsible for awareness, regulation, and decision-making (Khalsa et al., 2018). In Taoist and martial frameworks, this is the stage of refining jing or the raw essence, by bringing unconscious patterns into conscious alignment.

Iterative Self-Cultivation

Once somatic awareness becomes stable, iterative self-cultivation begins. “Iterative” means cyclical—one polishes the self repeatedly through mindful practice, reflection, and correction. In martial and meditative traditions, this is the ongoing cycle of practice → feedback → adjustment → integration. Each repetition deepens skill while gradually refining the character, much like tempering a sword through alternating heat and cooling.

This process embodies the principle of gongfu (功夫), the disciplined accumulation of effort over time. As the practitioner works through layers of physical, emotional, and cognitive conditioning, they develop what Confucian and Daoist classics call de (virtue or cultivated power). Modern psychology parallels this with neuroplastic adaptation—deliberate repetition that rewires synaptic pathways for stability, emotional regulation, and self-mastery (Davidson & McEwen, 2012).

Transmutation

Transmutation represents the culmination of these iterative refinements, the conversion of base tendencies into higher expression. In Taoist alchemy (neidan), it is the transformation of jing → qi → shen—essence into energy into spirit. Through calibrated awareness and continuous self-cultivation, internal friction and limitation become fuel for illumination.

In practical terms, transmutation is both psychological and energetic. It’s the capacity to metabolize fear into courage, pain into empathy, or adversity into wisdom. Physiologically, such transformation parallels shifts in endocrine and autonomic balance, where once-stressful stimuli now trigger coherence rather than reactivity. Spiritually, it marks the emergence of authenticity and radiant presence, the “light that guides others.”

Interconnection of the Three

Somatic calibration refines awareness and alignment.
Iterative self-cultivation builds discipline and stability.
Transmutation realizes integration and illumination.

Together, they form a living spiral rather than a straight line: each turn of cultivation enhances sensitivity (calibration), which allows deeper refinement (iteration), which in turn fuels higher transformation (transmutation). The cycle never ends, but rather it simply ascends toward subtler planes of being.

References:

Davidson, R. J., & McEwen, B. S. (2012). Social influences on neuroplasticity: Stress and interventions to promote well-being. Nature Neuroscience, 15(5), 689–695. https://doi.org/10.1038/nn.3093

Khalsa, S. S., Rudrauf, D., Damasio, A. R., & Davidson, R. J. (2018). Interoceptive awareness and its relationship to anxiety, depression, and well-being. Philosophical Transactions of the Royal Society B, 373(1741), 20170163. https://doi.org/10.1098/rstb.2017.0163

Four-Phase Expansion of the Jing–Qi–Shen Developmental Model

Phase 1 — Foundational Awareness: Somatic Calibration (Jing)

Phase 1 represents the foundational stage where the practitioner learns to attune their physical body, the Jing level, through heightened somatic awareness and physiological regulation. At this level, the focus is on:

Interoception: sensing internal signals such as breath, heartbeat, and muscular tension
Proprioception: detecting body position and micro-adjustments
Regulatory Responsiveness: adjusting posture, breathing, and alignment

Somatic calibration stabilizes the “base material” of the human system. In Taoist internal arts, this is the earliest refinement of Jing: raw essence becoming cleaner, clearer, and more governable.

Neuroscientifically, this phase strengthens communication between the insula (interoceptive awareness), anterior cingulate cortex (attention and motivation), and prefrontal cortex (regulation and decision-making). When these systems integrate, the practitioner becomes capable of sensing imbalances long before they erupt into dysfunction (Khalsa et al., 2018).

This phase is therefore concerned with:

Cultivating “felt sense”
Stabilizing the nervous system
Learning to “hear” the body
Establishing physical coherence

Without Phase 1, progression into deeper phases becomes imbalanced or potentially unsafe.

This is the Jing → stability transformation.

Phase 2 — Cyclical Refinement: Iterative Self-cultivation (Qi)

Once somatic clarity is established, the practitioner advances toward the mental-energetic domain, the Qi level. This phase introduces iterative practice and self-correction, forming the living engine of personal development.

Here, the operating principle is iteration:

Practice → feedback → correction → integration → renewed practice

Across martial arts, meditation, and qigong lineages, this cyclical refinement is recognized as gongfu (kung fu), not mere skill, but the cultivated discipline earned through dedicated repetition. Each iteration reshapes:

Motor pathways
Emotional patterns
Cognitive habits
Energetic circulation

Modern neuroscience parallels this with experience-dependent neuroplasticity or the gradual restructuring of brain networks for resilience, emotional regulation, and attentional stability (Davidson & McEwen, 2012).

Spiritually and philosophically, Phase 2 is where one begins forging de (virtue, cultivated inner power). The practitioner transitions from merely feeling the body to shaping the self.

At this stage, Qi becomes more coherent and directed. Mental habits are tuned, intentions sharpen, and discipline becomes embodied.

This is the Qi → refinement transformation.

Phase 3 — Synthetic Integration: Transmutation (Shen)

Phase 3 transitions from refinement into whole-system synthesis, corresponding to the Shen level, with awareness, meaning, and inner illumination.

Here the practitioner no longer simply adjusts the body (Phase 1) or trains the mind through iteration (Phase 2). Instead, they convert base tendencies into higher capacities. This includes:

fear → insight
pain → empathy
discipline → wisdom
adversity → meaning

This is the essence of transmutation in internal alchemy (neidan):

Jing → Qi → Shen → back to emptiness and clarity

Physiologically, this level parallels harmonization of endocrine rhythms, autonomic coherence, and emotional centers that once produced reactivity but now produce calm presence.

Psychologically, the practitioner embodies authenticity rather than performance. Their presence becomes stabilizing to others, as they can become “the light that guides.”

Phase 3 is where:

the body listens
the mind learns
consciousness reorients toward clarity

This is the Shen → illumination transformation.

Bring it all together – the Harmonization (Integration of Jing–Qi–Shen)

My diagrams and progression of images naturally imply a fourth phase, which is the integrative stage where Jing, Qi, and Shen no longer operate as separate domains but revolve in a recursive living spiral.

Here, the practitioner reaches a point where:

Somatic calibration is continuous and automatic
Iterative self-cultivation is self-initiating
Transmutation becomes a way of life
All three influence each other simultaneously

This is the phase where the circle completes itself yet continues upward, a spiral path rather than a linear one.

In this 4th Phase the practitioner embodies:

Physical alignment (Jing)
Effortless posture, efficient movement, regulated physiology.

Mental clarity and energetic coherence (Qi)
Stable attention, balanced emotions, refined intentions.

Spiritual awareness (Shen)
Insight, compassion, spaciousness, wisdom.

Harmonized integration
The practitioner is no longer “performing techniques” as
they have become the technique.

This is the lived outcome of the entire model of the Warrior, Scholar and Sage:

Somatic Calibration → Iterative Self-cultivation → Transmutation → Integrated Being.

How the Four Phases Correspond to my Diagrams (Stages 1–4)

Stage 1 (Jing/Qi/Shen circles):

Introduces the classical triad, three aspects as separate yet related.

Stage 2 (Physiology/Psychology/Philosophy overlay):

Connects each classical aspect with modern disciplines.
This becomes the foundation of Phase 1.

Stage 3 (Somatic Calibration / Iterative Self-cultivation / Transmutation overlay):

Maps each classical component into the three functional processes.
This is Phase 2 and Phase 3.

Stage 4 (Full elaborated diagram with figures):

Demonstrates the mature, embodied expression of all three components working in harmony.
This represents Phase 4.

Integrated Summary

Phase 1—Somatic Calibration: tuning the body (Jing), establishing stability and awareness.
Phase 2—Iterative Self-cultivation: tuning the mind (Qi), cultivating discipline, neuroplasticity, and virtuous habits.
Phase 3—Transmutation: tuning the consciousness (Shen), converting tendencies into illumination.
Phase 4—Recursive Harmonization: integrating Jing–Qi–Shen into a coherent, unified mode of being.

Together these phases describe a complete developmental alchemical model bridging Taoist tradition, neuroscience, psychology, and embodied martial philosophy.