Monday, October 27, 2014

Always query your diagnosis

I woke this morning with a warm feeling in my heart.  Yesterday we had another one of our very successful and satisfying seminar days which I share with Guy Caplan.
I always like to focus these days on diagnosing the elements in patients our participants want help with, or, as this time, diagnosing the participants themselves who want a clearer picture of their own element.  You will note that I say “a clearer picture” rather than a definite diagnosis.  This is something I insist upon, because I am so aware that a diagnosis can initially only be a tentative hypothesis and awaits confirmation from the way in which a patient responds to treatment.  In other words, we are never sure that we have the right guardian element until that element has shown us, through its positive reaction to treatment, that this treatment is directed in the right place along the circle of the elements.
I know that hovering over all five element acupuncturists is the picture of JR Worsley interacting with a patient for a few minutes, and then turning to us with an immediate diagnosis of one element.  This picture can delude us into thinking that every diagnosis we make should be equally as fast.  But, as JR told us as students, it had taken him more than 40 years’ hard work to get to the stage he had reached.  We would all be able to do the same, he said, once we had the same number of years’ practice behind us.  So those of us with far fewer years’ experience will have to accept that tracking an element down to its source in a patient takes more than just a few minutes, and very often many more than just a few treatments.
What I tell students is that no patient minds how long this takes provided they feel our compassion for them.  A practitioner, Jo, who has attended many of our seminars, has just sent me the following lovely quote:  People don't care what you know, they want to know that you care.”  As long as we show we care, a patient will trust us to know what we are doing and allow us the time to work out gradually which element we should address with our treatment.  We must never allow ourselves to be hurried by our patients into feeling that things should be moving more quickly than they are.  One of the things we were told as students was that it takes about a month of treatment for every year of illness.  That does not mean continuous weekly treatments, but it is a helpful rule of thumb, and allows us to tailor our expectations to a more realistic level.
Once my patients have started treatment, I have noticed that very few of them, if any, seem to spend much time talking about their symptoms, but instead want to talk about their life in general.  In fact they often forget altogether why they originally came to see me, evidence that patients do indeed want “care”, and not necessarily a “cure”, although with care often comes cure, since usually the two are closely related.
Our next seminar will be in the spring. In the meantime, Guy and I are off to China again in mid-November.  Our usual enthusiastic group of practitioners over there are again organizing a preparatory five element course for the people who will be attending for the first time so that we will be preaching already to the converted.  And luckily the new edition of the Mandarin version of my Handbook of Five Element Practice, with its Teach Yourself supplement, is flying off the shelves over there, and will give Chinese practitioners new to five element acupuncture a firm foundation on which to base their practice.




  1. I remember a story which Nora told us at one Seminar - having a conversation about acupuncture with a woman in a shop who showed great interest so she gave her one of her books to read more about it. I was lucky enough to have the opportunity, after attending a seminar held by Nora and Guy, to have the opportunity to buy lots of copies of Nora's book "A simple guide to acupuncture - The Five Elements". This little book has proved to be an invaluable tool in my treatment room in helping decide on the Guardian Element. When my patients first come for treatment I always explain to them the difference in Five Element acupuncture and TCM (from what I understand) and they are always intrigued! If they are interested to find out more I give them one of Nora's book which they take away with joy and intrigue. This, I find, greatly helps their treatment. Firstly because they come back and confirm to me what they think their Guardian Element is which greatly helps me because sometimes I miss little insights which they have not yet shared with me. They also understand more about their treatment and which in turn helps them. What is so lovely is that sometimes they give the book back to me so that I can pass it on to someone else or they are ask if they can pass it on to friends, family, boyfriends, girlfriends etc. A very precious book for both me and my patients and for many others to be introduced to the beauty of Five Elements. Thank you Nora for all your work on keeping Five Elements alive.

    1. Thank you, Aynsley. I'm glad my little book helps your patients understand their treatment better - which is why I wrote it!