Sunday, November 14, 2010

Uncertainties surrounding diagnosis in five element acupuncture

I have been reminded recently of an important fact about the realities of being a five element acupuncturist. An experienced practitioner of many years’ standing told me that what he finds difficult about five element acupuncture is that its practitioners often appear to change their minds as to their patients’ guardian elements, starting, say with working on the Metal element, and after some, or even many, treatments moving away on to Earth. He could not, he said, work in a discipline which offered him so little diagnostic certainty, and he was surprised that I did not find this as disturbing as he did. Instead, as I pointed out, I find it exhilarating that my discipline is open to accepting in this way the complexities, and perhaps ultimate unknowability, of a human being. When I asked him exactly what certainties his own practice gave him, we together eventually attributed this to the fact that his practice concentrated almost exclusively upon focusing his diagnosis upon physical criteria, for which he had learnt specific standardized treatment which hardly varied from patient to patient. Where, for example, did the patient experience pain? If in the knee, then he had a fixed protocol of points to deal with this, which came from his knowledge of the meridian pathways affected, and included additional treatments, such as ear acupuncture or cupping, which he had learnt specifically addressed physical problems.

When asked how he would deal with a patient telling him that he was finding it difficult coping with life, he fell silent and then admitted that, apart from offering some generalized sedative treatment to calm the patient, this was an area of his practice that he did not venture into. This was evidence to me of the different emphases different traditions place on specific aspects of a patient’s well-being. The central pillar of all five element practice is formed by those areas of what, in Western thought, we would call psychology. The same does not hold true for all other forms of acupuncture. This may also be one of the reasons why five element acupuncture appears to prompt much heated debate as to its validity and arouse a surprising degree of hostility for a branch of acupuncture which is so completely rooted in the deep spiritual traditions of the east upon which all acupuncture is based. You have only to read the classics, such as the Nei Jing, to appreciate how strongly bathed in the spirit were the traditions from which all acupuncture emerged. There was never a split between body and soul as there is on the whole in Western medicine, where psychology and physical medical practices lie far apart, and sadly, too, as there appears to be in modern Chinese acupuncture. To a five element acupuncturist, where no such split exists, or should exist, the emphasis upon a diagnosis based predominately upon physical symptoms therefore represents an oddity, only to be explained by an over-reliance on what appears to be physically there, to the detriment of what cannot be seen.

It may well be that a society over-dependent on the physically observable since the rise of science, and thus symbolically prizing the microscope over the touch of the hand or the glance of the eye, has forgotten how far the microscope only reveals, as it were, the physical dimension of things, but can never, unlike the human touch, reach their ephemeral hidden core. It is here that five element acupuncture approaches the realms of psychotherapy, the treatment of the soul, and where those who find such an approach either perplexing or disturbing may label it, as one practitioner, firmly embedded within the “acupuncture treats the physical” school, did, as “too airy-fairy for me”. If airy-fairy means spiritual, well then I would agree that this is a fairly accurate description, but without the overtone of disparagement attached to this remark. It is the “airy-fairyness” of what I do that fascinates me, because I regard the intangible inner core each human being possesses as dictating the health of the whole structure of body and soul and, in its response to treatment directed at it, creating the conditions which allow the health of the whole edifice to be restored.

But the practitioner who was disturbed by not being able to “know” with certainty what element a person is highlighted a valid point which deserves to be addressed. If the elements within us are such subtle manifestations that they are difficult to detect even for those with experience, how far does that invalidate the discipline of five element acupuncture as a whole, and, as corollary to this, what particular difficulties does this present to an inexperienced acupuncturist? Far from invalidating it, I believe it strengthens its right to call itself a true discipline, for it acknowledges all those areas which lie at the heart of human life and give them meaning. As to the problems it presents for a newly qualified acupuncturist, the lesson, here, is to remain aware of the uncertainties our practice arouses in all of us, experienced and less experienced alike, and not to deny their existence or belittle the problems they cause. If uncertainty is accepted as being a necessary component of all healing practices, which I believe it must be, since with such practices we are dealing with the complexities of the human being, we can each in our own way learn techniques for dealing with this, and thus lessen our fears.

My next blog will describe a method I have developed to help me cope better with the uncertainties of practice.

No comments:

Post a Comment