Thursday, April 30, 2015

Cutting diagnostic corners in China

When we were students, we were always being told that we must allow our patients plenty of time to get to know us as practitioners so that they feel safe to start talking honestly about the problems they face in life and the help that they are really asking for.  This is particularly so during our first interaction with them, which we call a Traditional Diagnosis (TD), to distinguish it from a purely Western medical diagnosis, something we were told never to hurry through. It is therefore ironic that, in China, time is the one thing we cannot ask for, since we are only there for a few days, and in those few days we are expected to achieve so much.  Indeed, it makes me sad sometimes to think how privileged our students at SOFEA were in the amount of individual time we dedicated to each of them – individual tutorials, individual supervision of their treatments – as much individual time as we felt each student needed.

If I compare this now to what we have to do in China, I am amazed that we have achieved so much based upon the little time we have to offer anything in the nature of individual tuition to the many, many students who crowd into our courses.  Nowhere am I more aware of this than in our efforts to offer each student a diagnosis of their own element as a foundation on which to build their future practice.  In England students carrying out a diagnosis are expected to spend up to two hours completing this, during which they cover a long list of questions about a patient’s physical and emotional issues, with the emphasis above all on establishing a good relationship with the patient.  But how do we condense this into what we want to offer our Chinese students, the 40-50 new ones coming to each seminar we give?

At first I thought that there was no way we could do this, but quickly realised how disappointed students were if we gave them no indication whatsoever of what their own element might be.  This started to have a negative effect on our teaching.  We would be helping them learn to diagnose the elements of the patients brought before the class, but then were doing nothing to give them any indication of their own.  And anybody who has been reading my blogs will know that I emphasize the importance of a practitioner understanding how their own element may be affecting the way they treat (see my blog of 17 October 2013 How important is it that a five element practitioner is sure of their own element?).  So we had to think of a different form of diagnosis to fit the very specific situation we were faced with. 

After a few hit-and-miss attempts at devising a way of carrying out diagnoses on as many students as possible in the extremely short time available, we now dedicate a very specific amount of time at each seminar to diagnosing, or at least attempting to diagnose, any new students coming to these seminars, as well as checking on those previously diagnosed to see whether we still agree with our original diagnosis. If we don’t, which of course happens, we are quite open about telling the group that we have changed our minds (or, more specifically, our senses have changed our minds!).  At the latest seminar a few weeks ago we diagnosed 45 practitioners in one morning, a feat which required much concentrated attention from Mei, Guy and me.

Although this is a cautionary tale of just how NOT to carry out a TD, I realise that increasingly we have become surprisingly efficient at seeing the elements in this highly pressurized situation.  We ask students to sit in groups of five in front of the class, each of them talking a little about anything they want to, and the three of us, Mei, Guy and I, observing them carefully.  After all five have spoken, we put our heads together and come up with what we call a provisional diagnosis, one that we tell them we may well change as the seminar progresses and we have more time to look at them.  It is interesting how the placing of one person next to the other often reveals very clearly their differences, showing up their elements by comparison with each other.  And we have become better and better at seeing these differences, and attributing them to one or other element.

To reinforce our diagnosis, each student is then given their first five element treatment by another participant (all of whom are qualified acupuncturists).  This consists of the Aggressive Energy drain (or, if we think this is necessary, the Dragons treatment followed by an AE drain), and finishes with the source points of the element we have diagnosed.  And then we continue to observe them carefully in class over the next few days to see whether we feel that our original diagnosis is confirmed, or not, and in particular whether it is corroborated by the effects of treatment.

This is NOT, I repeat NOT, how a five element diagnosis should be carried out, far from it.  But  “needs must….”, as they say.  I would, however, beg all five element practitioners not to skimp on the time they spend on carrying out a TD just because they are reading here what we have to do in China.  If only we had the amount of time to give our 45 new students which our patients in the UK are so lucky to be given!


  1. Perhaps this is a 'beautiful constraint', i.e. one that works in some way precisely because the usual time is not possible to indulge our thinking mindes; and you must rinstead ely more on your intuitive, less conscious processes.

  2. Thanks for the thought, Jeremy. You may well be right!